Provider Demographics
NPI:1851982284
Name:GREAVES, CINDY M (DPH)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:M
Last Name:GREAVES
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:TN
Mailing Address - Zip Code:38063-1736
Mailing Address - Country:US
Mailing Address - Phone:731-635-2232
Mailing Address - Fax:731-635-8939
Practice Address - Street 1:251 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:TN
Practice Address - Zip Code:38063-1736
Practice Address - Country:US
Practice Address - Phone:731-635-2232
Practice Address - Fax:731-635-8939
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6289183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist