Provider Demographics
NPI:1154461028
Name:STANDRIDGE, TARAH MICHELLE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:TARAH
Middle Name:MICHELLE
Last Name:STANDRIDGE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 VINEGAR RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37354-6400
Mailing Address - Country:US
Mailing Address - Phone:865-335-0462
Mailing Address - Fax:423-351-1547
Practice Address - Street 1:929 NEW HIGHWAY 68
Practice Address - Street 2:
Practice Address - City:SWEETWATER
Practice Address - State:TN
Practice Address - Zip Code:37874-2726
Practice Address - Country:US
Practice Address - Phone:423-351-1277
Practice Address - Fax:423-351-1547
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27047183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist