Provider Demographics
NPI:1275827339
Name:GOSS, DAVID EDWARD (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:EDWARD
Last Name:GOSS
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 1:1033 CROSSINGS BLVD
Mailing Address - Street 2:T-2362
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-2776
Mailing Address - Country:US
Mailing Address - Phone:931-489-6038
Mailing Address - Fax:931-489-6038
Practice Address - Street 1:1033 CROSSINGS BLVD
Practice Address - Street 2:T-2362
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-2776
Practice Address - Country:US
Practice Address - Phone:931-489-6038
Practice Address - Fax:931-489-6038
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10840183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist