MEDICARE: JAMES DAVID SOLOMON DPH

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	2987	TN

General Provider Information

NPI Number	:	1245522838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES DAVID SOLOMON DPH

Provider Business Mailing Address
First Line	:	450 HIGHWAY 72
Second Line	:
City	:	COLLIERVILLE
State	:	TN
Zip	:	38017-2804
Country	:	US
Telephone Number	:	901-853-2862
Fax Number	:	901-854-9582

Provider Business Practice Location Address
First Line	:	450 HIGHWAY 72
Second Line	:
City	:	COLLIERVILLE
State	:	TN
Zip	:	38017-2804
Country	:	US
Telephone Number	:	901-853-2862
Fax Number	:	901-854-9582

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

Provider Enumeration Date	:	05/13/2011
Last Update Date	:	05/13/2011

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