Provider Demographics
NPI:1457626087
Name:RAINEY, DAVID F (DPH)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:F
Last Name:RAINEY
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7428 OVERCREEK LN
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38133-2602
Mailing Address - Country:US
Mailing Address - Phone:901-606-8852
Mailing Address - Fax:
Practice Address - Street 1:7428 OVERCREEK LN
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38133-2602
Practice Address - Country:US
Practice Address - Phone:901-606-8852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-15
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000007932183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist