Healthcare Provider Details

I. General information

NPI: 1104421353
Provider Name (Legal Business Name): GRAYSON DEAN ECKERT PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2020
Last Update Date: 12/03/2020
Certification Date: 12/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 HILLSBORO PIKE
NASHVILLE TN
37215-2603
US

IV. Provider business mailing address

3801 HILLSBORO PIKE
NASHVILLE TN
37215-2603
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number40611
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: