Basic Information
Provider Information
NPI: 1326059361
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAMAR
FirstName: CHUCK
MiddleName: L.
NamePrefix: MR.
NameSuffix:  
Credential: RPH
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HAMAR
OtherFirstName: CHARLES
OtherMiddleName: L.
OtherNamePrefix: MR.
OtherNameSuffix:  
OtherCredential: RPH
OtherLastNameType: 2
Mailing Information
Address1: 1140 BATTERY LN
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372201033
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1310 24TH AVE S
Address2: VA MEDICAL CENTER
City: NASHVILLE
State: TN
PostalCode: 372122637
CountryCode: US
TelephoneNumber: 6153275335
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/11/2006
LastUpdateDate: 02/02/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000XC6286TNY Pharmacy Service ProvidersPharmacist 

No ID Information.


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