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NPI Code Detail

MEDICARE: DR. VICKIE C SUMMERS D.PH.

MEDICARE: DR. VICKIE C SUMMERS D.PH.
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
1183500000XPharmacist5029TN

General Provider Information

NPI Number : 1114928173
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VICKIE C SUMMERS D.PH.
Provider Business Mailing Address
First Line : 12935 PARIS ST
Second Line :
City : HUNTINGDON
State : TN
Zip : 38344-2738
Country : US
Telephone Number : 731-225-6714
Fax Number : 731-847-3788
Provider Business Practice Location Address
First Line : 179 TENNESSEE AVE N
Second Line :
City : PARSONS
State : TN
Zip : 38363-2002
Country : US
Telephone Number : 731-847-3784
Fax Number : 731-847-3788
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2005
Last Update Date : 07/08/2007

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