MEDICARE: KELLY NEIL 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	12256	TN
2	183500000X	Pharmacist	14505	AL

General Provider Information

NPI Number	:	1942282033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY NEIL PHARM D

Provider Business Mailing Address
First Line	:	431 KARSTRIDGE RD
Second Line	:
City	:	SMYRNA
State	:	TN
Zip	:	37167-5135
Country	:	US
Telephone Number	:	615-223-5717
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 CHURCH ST
Second Line	:	STE 650
City	:	NASHVILLE
State	:	TN
Zip	:	37219-2320
Country	:	US
Telephone Number	:	615-256-3023
Fax Number	:	615-255-3528

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

Provider Enumeration Date	:	11/15/2005
Last Update Date	:	09/03/2009

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Directions to “ KELLY NEIL PHARM D” Practice Location

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