Provider Demographics
NPI:1376854455
Name:CHOATE, LORI MICHELE (PHARMD)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:MICHELE
Last Name:CHOATE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 MEMORIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:TN
Mailing Address - Zip Code:37172-3915
Mailing Address - Country:US
Mailing Address - Phone:615-382-9388
Mailing Address - Fax:615-382-9371
Practice Address - Street 1:2115 MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:TN
Practice Address - Zip Code:37172
Practice Address - Country:US
Practice Address - Phone:615-382-9388
Practice Address - Fax:615-382-9371
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2011-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN34197183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN34197OtherSTATE LICENSE