Healthcare Provider Details

I. General information

NPI: 1336527456
Provider Name (Legal Business Name): CARDINAL HEALTH 128, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2015
Last Update Date: 05/08/2015
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: 866-716-5486
  • Fax: 866-750-0823
Mailing address:
  • Phone: 866-716-5486
  • Fax: 866-750-0823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number00003886
License Number StateTN

VIII. Authorized Official

Name: THOMAS HERRMANN
Title or Position: DIRECTOR, CLINICAL SERVICES
Credential:
Phone: 615-312-9852