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NPI Code Detail

MEDICARE: DR. STEVEN LEE DEMONBREUN PHARMD

MEDICARE: DR. STEVEN LEE DEMONBREUN 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
1183500000XPharmacist39180TN

General Provider Information

NPI Number : 1417339805
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEVEN LEE DEMONBREUN PHARMD
Provider Business Mailing Address
First Line : 1460 FORT CAMPBELL BLVD
Second Line :
City : CLARKSVILLE
State : TN
Zip : 37042-3553
Country : US
Telephone Number : 931-648-1134
Fax Number :
Provider Business Practice Location Address
First Line : 1460 FORT CAMPBELL BLVD
Second Line :
City : CLARKSVILLE
State : TN
Zip : 37042-3553
Country : US
Telephone Number : 931-648-1134
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2015
Last Update Date : 06/23/2015

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