Provider Demographics
NPI:1649581646
Name:OVERTON, PAIGE E (RPH)
Entity Type:Individual
Prefix:MS
First Name:PAIGE
Middle Name:E
Last Name:OVERTON
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 1:2340 HIGHWAY 394
Mailing Address - Street 2:
Mailing Address - City:BLOUNTVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37617-5319
Mailing Address - Country:US
Mailing Address - Phone:423-323-1656
Mailing Address - Fax:423-323-7264
Practice Address - Street 1:2340 HIGHWAY 394
Practice Address - Street 2:
Practice Address - City:BLOUNTVILLE
Practice Address - State:TN
Practice Address - Zip Code:37617-5319
Practice Address - Country:US
Practice Address - Phone:423-323-1656
Practice Address - Fax:423-323-7264
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-24
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000022878183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist