Provider Demographics
NPI:1467893248
Name:PLUNKETT, MALLORI ADRIANNE (PHARM D)
Entity Type:Individual
Prefix:
First Name:MALLORI
Middle Name:ADRIANNE
Last Name:PLUNKETT
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 1:805 NASHVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-2430
Mailing Address - Country:US
Mailing Address - Phone:931-215-4835
Mailing Address - Fax:
Practice Address - Street 1:805 NASHVILLE HWY
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-2430
Practice Address - Country:US
Practice Address - Phone:931-215-4835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-09
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN37528183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist