Healthcare Provider Details

I. General information

NPI: 1457310526
Provider Name (Legal Business Name): PARDUE'S PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2006
Last Update Date: 06/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 PATTERSON STREET SUITE 200
NASHVILLE TN
37203
US

IV. Provider business mailing address

1900 PATTERSON STREET SUITE 200
NASHVILLE TN
37203
US

V. Phone/Fax

Practice location:
  • Phone: 615-327-1350
  • Fax: 615-321-4764
Mailing address:
  • Phone: 615-327-1350
  • Fax: 615-327-4764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number946
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number228
License Number StateTN

VIII. Authorized Official

Name: SHELLY MARIE COLE
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 615-327-1350