Provider Demographics
NPI:1295223220
Name:YORK-KILBURN, TRACY (PHARM D)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:YORK-KILBURN
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 1:1285 SAVANNAH HWY
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:38485-4806
Mailing Address - Country:US
Mailing Address - Phone:931-722-6992
Mailing Address - Fax:
Practice Address - Street 1:175 J I BELL LANE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:TN
Practice Address - Zip Code:38372
Practice Address - Country:US
Practice Address - Phone:731-925-2506
Practice Address - Fax:731-925-5004
Is Sole Proprietor?:No
Enumeration Date:2018-04-25
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11379183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist