Provider Demographics
NPI:1669019188
Name:GRIMSHAW, COREY D (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:COREY
Middle Name:D
Last Name:GRIMSHAW
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 1:515 MADISON ST APT 414
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37208-1686
Mailing Address - Country:US
Mailing Address - Phone:865-804-3790
Mailing Address - Fax:
Practice Address - Street 1:TUCKER PHARMACY
Practice Address - Street 2:2415 FAIRVIEW BLVD
Practice Address - City:FAIRVIEW
Practice Address - State:TN
Practice Address - Zip Code:37062-3706
Practice Address - Country:US
Practice Address - Phone:615-799-0691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-03
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0199171835P0018X
VA02022179511835P0018X
TN402241835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist