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NPI Code Detail

MEDICARE: AMANDA SEARS MAYES PHARMD

MEDICARE: AMANDA SEARS MAYES 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
1183500000XPharmacist34382TN

General Provider Information

NPI Number : 1225314743
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA SEARS MAYES PHARMD
Provider Business Mailing Address
First Line : 804 FOXWOOD RD
Second Line :
City : CLARKSVILLE
State : TN
Zip : 37043-5939
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1954 MADISON ST
Second Line :
City : CLARKSVILLE
State : TN
Zip : 37043-8038
Country : US
Telephone Number : 931-552-8108
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2011
Last Update Date : 10/28/2011

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1538445309 — DALE ALAN CHRISTENSEN PHARMD
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1954 MADISON ST
CLARKSVILLE, TN
37043-8038
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Practice Fax: 931-552-9614

Directions to “ AMANDA SEARS MAYES PHARMD” Practice Location

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