Healthcare Provider Details

I. General information

NPI: 1144584863
Provider Name (Legal Business Name): BRANDON VETTER PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2012
Last Update Date: 10/26/2025
Certification Date: 10/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4449 HWY 70 E
WHITE BLUFF TN
37187-9268
US

IV. Provider business mailing address

400 HIGHWAY 149
CLARKSVILLE TN
37040-7237
US

V. Phone/Fax

Practice location:
  • Phone: 615-908-6121
  • Fax: 615-908-6141
Mailing address:
  • Phone: 931-233-0444
  • Fax: 931-278-6477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number36593
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: