Provider Demographics
NPI:1760598122
Name:CHATWOOD PHARMACY INC
Entity Type:Organization
Organization Name:CHATWOOD PHARMACY INC
Other - Org Name:GREEN HILLS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JARED
Authorized Official - Middle Name:
Authorized Official - Last Name:LONON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:615-334-1212
Mailing Address - Street 1:2140 BANDYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2703
Mailing Address - Country:US
Mailing Address - Phone:615-292-3359
Mailing Address - Fax:615-297-6153
Practice Address - Street 1:2140 BANDYWOOD DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-2703
Practice Address - Country:US
Practice Address - Phone:615-292-3359
Practice Address - Fax:615-297-6153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5783336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0231240001Medicare ID - Type Unspecified