MEDICARE: MEGANN MAYNARD PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	40284	TN

General Provider Information

NPI Number	:	1003269564
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGANN MAYNARD PHARMD

Provider Business Mailing Address
First Line	:	1106 N MAIN ST
Second Line	:
City	:	CROSSVILLE
State	:	TN
Zip	:	38555-4059
Country	:	US
Telephone Number	:	931-484-4388
Fax Number	:	931-456-5192

Provider Business Practice Location Address
First Line	:	1106 N MAIN ST
Second Line	:
City	:	CROSSVILLE
State	:	TN
Zip	:	38555-4059
Country	:	US
Telephone Number	:	931-484-4388
Fax Number	:	931-456-5192

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2016
Last Update Date	:	07/20/2016

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Directions to “ MEGANN MAYNARD PHARMD” Practice Location

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