Provider Demographics
NPI:1790117810
Name:KILDAY, DREW THOMAS (PHARM D)
Entity Type:Individual
Prefix:MR
First Name:DREW
Middle Name:THOMAS
Last Name:KILDAY
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 N FAIRMONT AVE
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-3768
Mailing Address - Country:US
Mailing Address - Phone:423-586-6263
Mailing Address - Fax:423-587-5460
Practice Address - Street 1:228 N FAIRMONT AVE
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-3768
Practice Address - Country:US
Practice Address - Phone:423-586-6263
Practice Address - Fax:423-587-5460
Is Sole Proprietor?:No
Enumeration Date:2013-07-31
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN37811183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN37811OtherTN BOARD OF PHARMACY