MEDICARE: MRS. KATHERINE LUCIUS ALSUP PHARM. D

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	11152	TN
2	183500000X	Pharmacist	35562	FL
3	183500000X	Pharmacist	19446	GA

General Provider Information

NPI Number	:	1861537706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATHERINE LUCIUS ALSUP PHARM. D

Provider Business Mailing Address
First Line	:	4020 OVERBROOK DR
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37204-4311
Country	:	US
Telephone Number	:	615-385-3735
Fax Number	:

Provider Business Practice Location Address
First Line	:	608 ENON SPRINGS RD E
Second Line	:
City	:	SMYRNA
State	:	TN
Zip	:	37167-4410
Country	:	US
Telephone Number	:	615-220-5432
Fax Number	:

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

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	07/08/2007

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