Provider Demographics
NPI:1619133592
Name:COST, MICAH JOEL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MICAH
Middle Name:JOEL
Last Name:COST
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1732 LEBANON PIKE CIR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37210-3216
Mailing Address - Country:US
Mailing Address - Phone:615-256-3023
Mailing Address - Fax:615-255-3528
Practice Address - Street 1:500 CHURCH ST
Practice Address - Street 2:SUITE 650
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37219-2320
Practice Address - Country:US
Practice Address - Phone:615-256-3023
Practice Address - Fax:615-255-3528
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2020-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33118183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist