Provider Demographics
NPI:1528232501
Name:SHRUM, LAINE A (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LAINE
Middle Name:A
Last Name:SHRUM
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 1:500 S WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-3727
Mailing Address - Country:US
Mailing Address - Phone:931-525-6240
Mailing Address - Fax:
Practice Address - Street 1:500 S WILLOW AVE
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-3727
Practice Address - Country:US
Practice Address - Phone:931-525-6240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-21
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29373183500000X
TN0000029373183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist