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General NPI Number Information
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NPI Number | 1922326362
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Entity Type | Individual
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Provider Name | MARY KOLB SUTHERLAND R.PH.
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Gender | Female
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Dates
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Enumeration Date | 05/10/2010
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Last Update Date | 05/10/2010
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Provider Practice Location Address
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Address Line | 305 SEABOARD LN SUITE 318
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City | FRANKLIN
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State | TN
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Zip | 37067-8287
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Country | US
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Telephone | 888-836-8821
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Fax | 888-836-8822
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Provider Business Mailing Address
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Address Line | 1692 AUTUMN PL
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City | BRENTWOOD
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State | TN
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Zip | 37027-3340
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Country | US
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Telephone | 615-308-5314
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Fax | 888-836-8822
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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 | 10290
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License Number State | TN
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