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General NPI Number Information
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NPI Number | 1467739276
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Entity Type | Individual
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Provider Name | MINDY DEAL PHARMD
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Gender | Female
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Dates
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Enumeration Date | 11/08/2011
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Last Update Date | 11/08/2011
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Provider Practice Location Address
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Address Line | 826 N MAIN ST
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City | SHELBYVILLE
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State | TN
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Zip | 37160-2845
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Country | US
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Telephone | 931-680-4725
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Fax |
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Provider Business Mailing Address
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Address Line | 119 HIGDON CIR
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City | MANCHESTER
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State | TN
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Zip | 37355-4392
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Country | US
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Telephone | 931-728-7624
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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 | 28472
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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 | 14586
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License Number State | AL
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