Provider Demographics
NPI:1093318917
Name:YORK, LOURDES (PHARMD)
Entity Type:Individual
Prefix:
First Name:LOURDES
Middle Name:
Last Name:YORK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5705 GLENLYN DR
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-4959
Mailing Address - Country:US
Mailing Address - Phone:865-773-9673
Mailing Address - Fax:
Practice Address - Street 1:417 E EMORY RD
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37849-3518
Practice Address - Country:US
Practice Address - Phone:865-938-5411
Practice Address - Fax:865-938-5423
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-21
Last Update Date:2020-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN32302183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist