Provider Demographics
NPI:1629107651
Name:MARGRAVE, PAULA A (RPH)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:A
Last Name:MARGRAVE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 234
Mailing Address - Street 2:
Mailing Address - City:HARRIMAN
Mailing Address - State:TN
Mailing Address - Zip Code:37748-0234
Mailing Address - Country:US
Mailing Address - Phone:865-882-1675
Mailing Address - Fax:
Practice Address - Street 1:ROANE PLAZA HWY 27
Practice Address - Street 2:FOOD CITY PHARMACEY #634
Practice Address - City:HARRIMAN
Practice Address - State:TN
Practice Address - Zip Code:37748
Practice Address - Country:US
Practice Address - Phone:865-882-0117
Practice Address - Fax:865-882-7698
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN836183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist