Healthcare Provider Details

I. General information

NPI: 1427056563
Provider Name (Legal Business Name): CHRISTOPHER GLEN MASTERS PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 SEWELL DR
SPARTA TN
38583-1223
US

IV. Provider business mailing address

4200 DEERFIELD LN
COOKEVILLE TN
38506-7063
US

V. Phone/Fax

Practice location:
  • Phone: 931-738-4169
  • Fax: 931-738-4179
Mailing address:
  • Phone: 931-528-6743
  • Fax: 931-738-4179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number10087
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number10087
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: