1235308875 NPI number — MRS. MARSHA JONES HOLLINS PHARMACIST

Table of content: MRS. MARSHA JONES HOLLINS PHARMACIST (NPI 1235308875)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235308875 NPI number — MRS. MARSHA JONES HOLLINS PHARMACIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOLLINS
Provider First Name:
MARSHA
Provider Middle Name:
JONES
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PHARMACIST
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
JONES
Provider Other First Name:
MARSHA
Provider Other Middle Name:
TERRY
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHARMACIST
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1235308875
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/28/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4450 NEW MANCHESTER HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TULLAHOMA
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37388-6756
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
931-455-7590
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
909 N WASHINGTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TULLAHOMA
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37388-2313
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
931-455-1423
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/28/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  0000004111 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com