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General NPI Number Information
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NPI Number | 1992292825
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Entity Type | Individual
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Provider Name | ROBERT M SELF R.PH.
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Gender | Male
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Dates
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Enumeration Date | 04/17/2018
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Last Update Date | 06/04/2019
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Provider Practice Location Address
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Address Line | 200 CHICKASAW RIDGE DR STE 25
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City | OAKLAND
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State | TN
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Zip | 38060-6208
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Country | US
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Telephone | 901-290-0428
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Fax |
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Provider Business Mailing Address
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Address Line | 200 CHICKASAW RIDGE DR STE 25
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City | OAKLAND
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State | TN
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Zip | 38060-6208
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Country | US
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Telephone | 901-290-0428
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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 | 11529
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License Number State | AL
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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 | 051297704
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 019210
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License Number State | LA
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 46605
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 9841
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License Number State | MS
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Taxonomy #6
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 15809
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License Number State | GA
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Taxonomy #7
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 34102
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License Number State | TN
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