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NPI Code Detail

MEDICARE: DR. ANGELA KAY BALLOU PHARM. D.

MEDICARE: DR. ANGELA KAY BALLOU PHARM. D.
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
1183500000XPharmacist7635TN

General Provider Information

NPI Number : 1023013844
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANGELA KAY BALLOU PHARM. D.
Provider Business Mailing Address
First Line : 1600 OAKDALE RD
Second Line :
City : WESTMORELAND
State : TN
Zip : 37186-2942
Country : US
Telephone Number : 615-688-6337
Fax Number : 615-688-6338
Provider Business Practice Location Address
First Line : 207 HIGHWAY 52 BYP W
Second Line :
City : LAFAYETTE
State : TN
Zip : 37083-1728
Country : US
Telephone Number : 615-688-6337
Fax Number : 615-688-6338
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2005
Last Update Date : 07/08/2007

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