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General NPI Number Information
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NPI Number | 1083796445
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Entity Type | Individual
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Provider Name | CHASITY L KILGORE CPHT
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Gender | Female
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 208 SUNCREST ST SUITE1
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City | GRAY
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State | TN
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Zip | 37615-3494
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Country | US
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Telephone | 423-384-7720
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Fax |
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Provider Business Mailing Address
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Address Line | 3304 GRIMES CIRCLE
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City | KINGSPORT
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State | TN
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Zip | 37663
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Country | US
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Telephone | 423-384-7720
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 270100103111766
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License Number State | TN
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