MEDICARE: DR. JONATHAN ROBERT KUZMICH 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	39604	TN

General Provider Information

NPI Number	:	1952069544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONATHAN ROBERT KUZMICH PHARM.D.

Provider Business Mailing Address
First Line	:	1117 STOCKELL ST
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37207-5450
Country	:	US
Telephone Number	:	219-707-7377
Fax Number	:

Provider Business Practice Location Address
First Line	:	1117 STOCKELL ST
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37207-5450
Country	:	US
Telephone Number	:	219-707-7377
Fax Number	:

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

Provider Enumeration Date	:	12/01/2021
Last Update Date	:	12/01/2021

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