Basic Information
| Provider Information | |||||||||
| NPI: | 1720196827 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARNETT | ||||||||
| FirstName: | LARRY | ||||||||
| MiddleName: | DUDLEY | ||||||||
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| Credential: | RPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2390 GREENWOOD RD | ||||||||
| Address2: | |||||||||
| City: | COLLEGE GROVE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370465102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9313647715 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1310 24TH AVE S | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372122637 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153275335 | ||||||||
| FaxNumber: | 6153216310 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/28/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 131 | TN | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.