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General NPI Number Information
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NPI Number | 1821989773
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Entity Type | Individual
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Provider Name | DAVID RIDDELL III
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Gender | Male
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Dates
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Enumeration Date | 07/10/2025
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 775 PICKWICK ST
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City | SAVANNAH
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State | TN
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Zip | 38372-3053
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Country | US
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Telephone | 731-925-6200
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Fax |
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Provider Business Mailing Address
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Address Line | 855 CHURCH ST
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City | SAVANNAH
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State | TN
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Zip | 38372-1163
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Country | US
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Telephone | 731-926-0337
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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 | 49100
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License Number State | TN
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