Provider Demographics
NPI:1649567637
Name:GEMINN, WESLEY LOUIS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:WESLEY
Middle Name:LOUIS
Last Name:GEMINN
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 1:4424 LEBANON PIKE
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-1312
Mailing Address - Country:US
Mailing Address - Phone:901-292-3579
Mailing Address - Fax:
Practice Address - Street 1:4424 LEBANON PIKE
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-1312
Practice Address - Country:US
Practice Address - Phone:901-292-3579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-29
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35788183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN35788OtherTN LICENSE