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General NPI Number Information
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NPI Number | 1548764699
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Entity Type | Individual
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Provider Name | ANN TACH RPH
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Gender | Female
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Dates
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Enumeration Date | 03/22/2018
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Last Update Date | 03/22/2018
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Provider Practice Location Address
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Address Line | 320 W 18TH ST
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City | HOPKINSVILLE
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State | KY
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Zip | 42240-1965
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Country | US
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Telephone | 270-887-0166
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Fax |
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Provider Business Mailing Address
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Address Line | 3423 WELLINGTON PL
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City | MURFREESBORO
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State | TN
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Zip | 37128-0713
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Country | US
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Telephone |
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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 | 41393
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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 | 019474
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License Number State | KY
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