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General NPI Number Information
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NPI Number | 1073149548
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Entity Type | Organization
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Legal Business Name | CORDANT PHARMACY TENNESSEE, LLC
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Dates
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Enumeration Date | 03/17/2020
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Last Update Date | 08/18/2021
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Provider Practice Location Address
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Address Line | 640 SPENCE LN STE 220
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City | NASHVILLE
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State | TN
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Zip | 37217-1278
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Country | US
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Telephone | 615-709-2980
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Fax | 629-222-1093
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Provider Business Mailing Address
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Address Line | 12015 E 46TH AVE STE 220
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City | DENVER
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State | CO
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Zip | 80239-3107
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Country | US
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Telephone | 303-974-4023
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Fax |
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Authorized Official
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Title or Position | CHIEF OF STAFF
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Name | BRADLEY ECKMANN
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Credential |
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Telephone | 303-974-4023
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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