Provider Demographics
NPI:1043097546
Name:NEAL, PRESTON WADE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PRESTON
Middle Name:WADE
Last Name:NEAL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 GRANGE ST
Mailing Address - Street 2:
Mailing Address - City:PIPERTON
Mailing Address - State:TN
Mailing Address - Zip Code:38017-1083
Mailing Address - Country:US
Mailing Address - Phone:901-351-3777
Mailing Address - Fax:
Practice Address - Street 1:6697 STAGE RD
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-3867
Practice Address - Country:US
Practice Address - Phone:901-373-6498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN47383183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist