MEDICARE: DAVID TYLER AMMARELL

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	36883	TN

General Provider Information

NPI Number	:	1639772908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID TYLER AMMARELL

Provider Business Mailing Address
First Line	:	624 GRASSMERE PARK STE 22
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-3671
Country	:	US
Telephone Number	:	615-726-0776
Fax Number	:

Provider Business Practice Location Address
First Line	:	624 GRASSMERE PARK STE 22
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-3671
Country	:	US
Telephone Number	:	615-726-0776
Fax Number	:

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

Provider Enumeration Date	:	11/19/2020
Last Update Date	:	02/27/2026

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