Provider Demographics
NPI:1073143632
Name:TENNESSEE ONCOLOGY PHARMACY DISPENSING
Entity Type:Organization
Organization Name:TENNESSEE ONCOLOGY PHARMACY DISPENSING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PAYER RELATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATTIE
Authorized Official - Middle Name:Y
Authorized Official - Last Name:DOUGLAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-514-6876
Mailing Address - Street 1:2004 HAYES ST STE 800
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2659
Mailing Address - Country:US
Mailing Address - Phone:615-329-0570
Mailing Address - Fax:
Practice Address - Street 1:300 STONECREST BLVD STE 400
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-6802
Practice Address - Country:US
Practice Address - Phone:615-355-1770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TENNESSEE ONCOLOGY PHARMACY DISPENSING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-23
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site