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General NPI Number Information
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NPI Number | 1447503362
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Entity Type | Individual
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Provider Name | MARY JANIS TAYLOR B. S. PHARMACY
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Gender | Female
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Dates
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Enumeration Date | 10/16/2012
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Last Update Date | 10/16/2012
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Provider Practice Location Address
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Address Line | 323 NASH AVE
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City | COOKEVILLE
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State | TN
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Zip | 38501-3692
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Country | US
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Telephone | 931-982-0191
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Fax | 847-747-1608
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Provider Business Mailing Address
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Address Line | 323 NASH AVE
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City | COOKEVILLE
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State | TN
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Zip | 38501-3692
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Country | US
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Telephone | 931-982-0191
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Fax | 847-747-1608
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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 | 33797
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License Number State | TN
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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 | 13357
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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 | PS24191
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License Number State | FL
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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 | E07649
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License Number State | MS
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