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General NPI Number Information
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NPI Number | 1568732766
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Entity Type | Individual
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Provider Name | MRS. MARY GENEVA LAWSON
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Gender | Female
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Dates
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Enumeration Date | 01/04/2012
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Last Update Date | 12/20/2022
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Provider Practice Location Address
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Address Line | 957 ELM GROVE CR
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City | COLLIERVILLE
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State | TN
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Zip | 38107
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Country | US
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Telephone | 901-861-3910
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Fax |
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Provider Business Mailing Address
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Address Line | 8035 E SHELBY DR
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City | MEMPHIS
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State | TN
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Zip | 38125-3202
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Country | US
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Telephone | 901-753-2431
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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 | 8825
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License Number State | TN
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