Healthcare Provider Details

I. General information

NPI: 1891778841
Provider Name (Legal Business Name): CARDINAL HEALTH 128 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2005
Last Update Date: 03/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 CUMBERLAND BND
NASHVILLE TN
37228-1804
US

IV. Provider business mailing address

202 CUMBERLAND BND
NASHVILLE TN
37228-1804
US

V. Phone/Fax

Practice location:
  • Phone: 615-467-6009
  • Fax: 615-467-6008
Mailing address:
  • Phone: 866-716-5486
  • Fax: 615-244-2621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number3886
License Number StateTN

VIII. Authorized Official

Name: TOM HERRMANN
Title or Position: DIRECTOR CLINICAL OPERATIONS
Credential:
Phone: 615-312-9852