MEDICARE: DR. TERREL CHAPMAN D.PH

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	C-4415	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C-4415	OTHER	TN	LISCENSE NUMBER

General Provider Information

NPI Number	:	1548345093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TERREL CHAPMAN D.PH

Provider Business Mailing Address
First Line	:	3762 MASONWOOD LN
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38116-4012
Country	:	US
Telephone Number	:	901-345-1476
Fax Number	:	901-345-4090

Provider Business Practice Location Address
First Line	:	1977 S 3RD ST
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38109-7713
Country	:	US
Telephone Number	:	901-946-8852
Fax Number	:	901-942-6308

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

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	07/08/2007

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