Provider Demographics
NPI:1083725212
Name:POWELL, PAUL R (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:R
Last Name:POWELL
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:403 GREAT SUN CT
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37127-6347
Mailing Address - Country:US
Mailing Address - Phone:615-890-2663
Mailing Address - Fax:
Practice Address - Street 1:3400 LEBANON RD
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-1237
Practice Address - Country:US
Practice Address - Phone:615-867-6000
Practice Address - Fax:615-867-5924
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3164183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist