Healthcare Provider Details

I. General information

NPI: 1699807115
Provider Name (Legal Business Name): BARRY JAMES GREEN D.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3045 LYNCHBURG RD
WINCHESTER TN
37398-3659
US

IV. Provider business mailing address

3045 LYNCHBURG RD
WINCHESTER TN
37398-3659
US

V. Phone/Fax

Practice location:
  • Phone: 931-967-5444
  • Fax: 877-312-2351
Mailing address:
  • Phone: 931-967-5444
  • Fax: 877-312-2351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License NumberC-5302
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberC-5302
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: