Healthcare Provider Details

I. General information

NPI: 1467776443
Provider Name (Legal Business Name): RHONDA ANN MAYNARD PHARM. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2010
Last Update Date: 08/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 COLLEGE ST
SPENCER TN
38585-3214
US

IV. Provider business mailing address

88 COLLINWOOD CV
MCMINNVILLE TN
37110-4872
US

V. Phone/Fax

Practice location:
  • Phone: 931-946-7900
  • Fax: 931-946-8900
Mailing address:
  • Phone: 931-668-7470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number21821
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: