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General NPI Number Information
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NPI Number | 1316311418
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Entity Type | Organization
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Legal Business Name | INCEPTION RX
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Dates
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Enumeration Date | 11/30/2015
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Last Update Date | 08/14/2019
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Provider Practice Location Address
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Address Line | 343 FRANKLIN ROAD SUITE 200
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City | BRENTWOOD
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State | TN
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Zip | 37027-4637
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Country | US
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Telephone | 629-203-6022
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Fax | 615-376-4707
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Provider Business Mailing Address
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Address Line | PO BOX 1007
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City | BRENTWOOD
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State | TN
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Zip | 37024-1007
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Country | US
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Telephone | 629-203-6022
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Fax | 615-376-4707
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Authorized Official
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Title or Position | OWNER
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Name | KEVIN R. HARTMAN
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Credential | PHARMD
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Telephone | 615-371-1210
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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 | 5701
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License Number State | TN
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