Provider Demographics
NPI:1164173225
Name:TODD, JORDAN ROSS (PHARMD)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:ROSS
Last Name:TODD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 THOMPSON LN STE 24130
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-4677
Mailing Address - Country:US
Mailing Address - Phone:615-322-5353
Mailing Address - Fax:615-322-0808
Practice Address - Street 1:719 THOMPSON LN STE 24130
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-4677
Practice Address - Country:US
Practice Address - Phone:615-322-5353
Practice Address - Fax:615-322-0808
Is Sole Proprietor?:No
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN410521835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care