Provider Demographics
NPI:1083680169
Name:GROOMS, CHRISTENA HOPE (CPHT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTENA
Middle Name:HOPE
Last Name:GROOMS
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 HELENWOOD LOOP RD
Mailing Address - Street 2:
Mailing Address - City:HELENWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37755-5509
Mailing Address - Country:US
Mailing Address - Phone:423-569-5158
Mailing Address - Fax:
Practice Address - Street 1:950 BAKER HWY
Practice Address - Street 2:SUITE #1
Practice Address - City:HUNTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37756-4168
Practice Address - Country:US
Practice Address - Phone:423-663-9355
Practice Address - Fax:423-663-3992
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17932183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician