Provider Demographics
NPI:1346674058
Name:PIERCE, BRENT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRENT
Middle Name:
Last Name:PIERCE
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 1:222 CHESTER LEVEE RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38301-7504
Mailing Address - Country:US
Mailing Address - Phone:731-217-1847
Mailing Address - Fax:
Practice Address - Street 1:2401 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:HUMBOLDT
Practice Address - State:TN
Practice Address - Zip Code:38343-1753
Practice Address - Country:US
Practice Address - Phone:731-784-2613
Practice Address - Fax:731-784-7410
Is Sole Proprietor?:No
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN36783183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist