Basic Information
Provider Information
NPI: 1790048783
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOFFMANN
FirstName: TERRY
MiddleName: J.
NamePrefix:  
NameSuffix:  
Credential: RPH, PHARMD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3400 LEBANON RD
Address2:  
City: MURFREESBORO
State: TN
PostalCode: 371291392
CountryCode: US
TelephoneNumber: 6158676000
FaxNumber:  
Practice Location
Address1: 3400 LEBANON RD
Address2:  
City: MURFREESBORO
State: TN
PostalCode: 371291392
CountryCode: US
TelephoneNumber: 6158676000
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/24/2012
LastUpdateDate: 10/08/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000X5957SDY Pharmacy Service ProvidersPharmacist 

No ID Information.


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