MEDICARE: ANN M ALLEN 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	0000004346	TN

General Provider Information

NPI Number	:	1508133273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN M ALLEN DPH

Provider Business Mailing Address
First Line	:	4209 CECIL CT S
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37207-1204
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	355 NEW SHACKLE ISLAND RD
Second Line	:
City	:	HENDERSONVILLE
State	:	TN
Zip	:	37075-2479
Country	:	US
Telephone Number	:	615-338-2690
Fax Number	:

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

Provider Enumeration Date	:	11/24/2011
Last Update Date	:	11/24/2011

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