Provider Demographics
NPI:1437921103
Name:JOBEHDARI, HAMIDREZA CODY (PHARM D)
Entity Type:Individual
Prefix:
First Name:HAMIDREZA
Middle Name:CODY
Last Name:JOBEHDARI
Suffix:
Gender:M
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 1:511 ACKLEN PARK DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2365
Mailing Address - Country:US
Mailing Address - Phone:615-877-5447
Mailing Address - Fax:
Practice Address - Street 1:482 INTERSTATE DR STE K
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37355-3486
Practice Address - Country:US
Practice Address - Phone:931-563-0008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN22520183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist