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General NPI Number Information
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NPI Number | 1063583276
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Entity Type | Organization
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Legal Business Name | DONELSON DRUG MART
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Dates
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Enumeration Date | 11/10/2006
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Last Update Date | 02/29/2008
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Provider Practice Location Address
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Address Line | 2608 LEBANON PIKE
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City | NASHVILLE
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State | TN
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Zip | 37214-2403
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Country | US
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Telephone | 615-883-8515
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Fax | 615-883-8553
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Provider Business Mailing Address
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Address Line | 2608 LEBANON PIKE
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City | NASHVILLE
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State | TN
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Zip | 37214-2403
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Country | US
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Telephone | 615-883-8515
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Fax | 615-883-8553
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Authorized Official
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Title or Position | OWNER
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Name | MR. JAMES SHELLY
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Credential | DPH
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Telephone | 615-883-8515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2159
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License Number State | TN
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