Healthcare Provider Details

I. General information

NPI: 1316566862
Provider Name (Legal Business Name): GRANT CHARLES HARDER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2020
Last Update Date: 04/15/2020
Certification Date: 04/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 BELMONT BLVD
NASHVILLE TN
37212-3758
US

IV. Provider business mailing address

2114 KIRKWALL DR
NOLENSVILLE TN
37135-2000
US

V. Phone/Fax

Practice location:
  • Phone: 615-460-6000
  • Fax:
Mailing address:
  • Phone: 716-316-1529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: