Healthcare Provider Details

I. General information

NPI: 1942925961
Provider Name (Legal Business Name): JACQUES LECORPS PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2022
Last Update Date: 10/12/2022
Certification Date: 10/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 HILLSBORO RD
NASHVILLE TN
37215-2603
US

IV. Provider business mailing address

1715 WARFIELD DR
NASHVILLE TN
37215-3528
US

V. Phone/Fax

Practice location:
  • Phone: 615-385-0622
  • Fax:
Mailing address:
  • Phone: 161-550-4589
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number33368
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: