Healthcare Provider Details

I. General information

NPI: 1265864722
Provider Name (Legal Business Name): MOLLY S. HURST PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2013
Last Update Date: 08/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 24TH AVE S
NASHVILLE TN
37212-2637
US

IV. Provider business mailing address

1310 24TH AVE S
NASHVILLE TN
37212-2637
US

V. Phone/Fax

Practice location:
  • Phone: 615-873-7694
  • Fax:
Mailing address:
  • Phone: 615-873-7694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number14172
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: