Provider Demographics
NPI:1073149548
Name:CORDANT PHARMACY TENNESSEE, LLC
Entity Type:Organization
Organization Name:CORDANT PHARMACY TENNESSEE, LLC
Other - Org Name:CORDANT PHARMACY SOLUTIONS #203
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OF STAFF
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ECKMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-974-4023
Mailing Address - Street 1:12015 E 46TH AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80239-3107
Mailing Address - Country:US
Mailing Address - Phone:303-974-4023
Mailing Address - Fax:
Practice Address - Street 1:640 SPENCE LN STE 220
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-1278
Practice Address - Country:US
Practice Address - Phone:615-709-2980
Practice Address - Fax:629-222-1093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-17
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy