Provider Demographics
NPI:1093411258
Name:AGHAGOLI, AMIR
Entity Type:Individual
Prefix:DR
First Name:AMIR
Middle Name:
Last Name:AGHAGOLI
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:AMIR
Other - Middle Name:AGHA
Other - Last Name:GOLI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:220 ELDON CT
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-2226
Mailing Address - Country:US
Mailing Address - Phone:615-635-9010
Mailing Address - Fax:
Practice Address - Street 1:1104 ROSA L PARKS BLVD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37208-2520
Practice Address - Country:US
Practice Address - Phone:615-244-3730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN45603183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist