Basic Information
| Provider Information | |||||||||
| NPI: | 1699152066 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VA TENNESSEE VALLEY HEALTHCARE SYSTEM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1310 24TH AVE S | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372122637 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153274751 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1310 24TH AVE S | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372122637 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153274751 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2015 | ||||||||
| LastUpdateDate: | 05/05/2015 | ||||||||
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| AuthorizedOfficialLastName: | MCFARLAND | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | SHAWN | ||||||||
| AuthorizedOfficialTitleorPosition: | ASSOCIATE SERVICE CHIEF OF PHARMACY | ||||||||
| AuthorizedOfficialTelephone: | 6156301482 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | PHARM.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835P0018X | 12083 | TN | Y | 193400000X SINGLE SPECIALTY GROUP | Pharmacy Service Providers | Pharmacist | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
No ID Information.