MEDICARE: MRS. KIMBERLY K PIRTLE 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
1	183500000X	Pharmacist	11595	TN

General Provider Information

NPI Number	:	1083839310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KIMBERLY K PIRTLE PHARM. D.

Provider Business Mailing Address
First Line	:	8533 KELSEY CHEL CT
Second Line	:
City	:	OOLTEWAH
State	:	TN
Zip	:	37363-6297
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 RIVERSIDE DR
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37406-4309
Country	:	US
Telephone Number	:	423-386-1112
Fax Number	:

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

Provider Enumeration Date	:	04/13/2007
Last Update Date	:	08/09/2013

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