Healthcare Provider Details

I. General information

NPI: 1689126419
Provider Name (Legal Business Name): SANTO MANCIAMELI PHARMD.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2016
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 21ST AVE S
NASHVILLE TN
37212-4906
US

IV. Provider business mailing address

2201 21ST AVE S
NASHVILLE TN
37212-4906
US

V. Phone/Fax

Practice location:
  • Phone: 615-269-6641
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number062391
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number45907
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: