Provider Demographics
NPI:1164891594
Name:SHRUM, CASEY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CASEY
Middle Name:
Last Name:SHRUM
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 1:1000 GAINESBORO HWY
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:TN
Mailing Address - Zip Code:38551-5011
Mailing Address - Country:US
Mailing Address - Phone:931-243-2673
Mailing Address - Fax:931-243-4691
Practice Address - Street 1:1000 GAINESBORO HWY
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:TN
Practice Address - Zip Code:38551-5011
Practice Address - Country:US
Practice Address - Phone:931-243-2673
Practice Address - Fax:931-243-4691
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-16
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN39668183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist