MEDICARE: KIMBERLY D PEEBLES RPH

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	9137	TN

General Provider Information

NPI Number	:	1366780504
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY D PEEBLES RPH

Provider Business Mailing Address
First Line	:	517 ROCHELLE DR
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37220-2045
Country	:	US
Telephone Number	:	615-333-7228
Fax Number	:

Provider Business Practice Location Address
First Line	:	8028 HIGHWAY 100
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37221-4212
Country	:	US
Telephone Number	:	615-673-2756
Fax Number	:

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

Provider Enumeration Date	:	01/23/2013
Last Update Date	:	01/23/2013

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