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NPI Code Detail

MEDICARE: TOMIKA FULCHER

MEDICARE: TOMIKA FULCHER
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
1183500000XPharmacist0000029220TN

General Provider Information

NPI Number : 1750666061
Entity Type Code : Individual
Provider Name (Legal Business Name) : TOMIKA FULCHER
Provider Business Mailing Address
First Line : 3601 WADE GREEN WAY
Second Line :
City : KNOXVILLE
State : TN
Zip : 37931-1451
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1299 OAK RIDGE TPKE
Second Line :
City : OAK RIDGE
State : TN
Zip : 37830-6406
Country : US
Telephone Number : 865-482-4828
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2011
Last Update Date : 10/18/2011

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Directions to “ TOMIKA FULCHER ” Practice Location

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