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General NPI Number Information
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NPI Number | 1164903837
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Entity Type | Individual
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Provider Name | TANDY BRANHAM PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/22/2018
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Last Update Date | 08/22/2018
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Provider Practice Location Address
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Address Line | 527 N STATE OF FRANKLIN RD
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City | JOHNSON CITY
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State | TN
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Zip | 37604-8210
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Country | US
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Telephone | 423-975-0597
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Fax | 423-975-6304
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Provider Business Mailing Address
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Address Line | 179 LAKEVIEW ST
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City | GRAY
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State | TN
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Zip | 37615-3009
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Country | US
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Telephone | 276-451-1554
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 27623
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 20253
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 019789
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202216454
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 41295
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License Number State | TN
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