MEDICARE: AUSTIN SUN RPH

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	46397	TN

General Provider Information

NPI Number	:	1811607302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUSTIN SUN RPH

Provider Business Mailing Address
First Line	:	7201 CHARLOTTE PIKE APT 249
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37209-5067
Country	:	US
Telephone Number	:	731-217-3559
Fax Number	:

Provider Business Practice Location Address
First Line	:	8141 HIGHWAY 100
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37221-4213
Country	:	US
Telephone Number	:	615-662-6661
Fax Number	:

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

Provider Enumeration Date	:	11/25/2022
Last Update Date	:	11/25/2022

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