Provider Demographics
NPI:1699041830
Name:SAID, IRENE ADEL LEWIS
Entity Type:Individual
Prefix:
First Name:IRENE ADEL LEWIS
Middle Name:
Last Name:SAID
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6670 CHARLOTTE PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-4202
Mailing Address - Country:US
Mailing Address - Phone:615-354-5109
Mailing Address - Fax:615-354-5106
Practice Address - Street 1:6670 CHARLOTTE PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-4202
Practice Address - Country:US
Practice Address - Phone:615-354-5109
Practice Address - Fax:615-354-5106
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-30
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35436183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist