Healthcare Provider Details

I. General information

NPI: 1891703625
Provider Name (Legal Business Name): JAMES I. MINNIS RPH,PHARMD,BCPS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 03/08/2024
Certification Date: 03/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 24TH AVE S PHARMACY
NASHVILLE TN
37212-2637
US

IV. Provider business mailing address

104 FAWN TRL
BURNS TN
37029-5428
US

V. Phone/Fax

Practice location:
  • Phone: 615-327-4751
  • Fax: 615-321-6310
Mailing address:
  • Phone: 615-412-4605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number11269
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: