Provider Demographics
NPI:1922199009
Name:PHIPPS, MALEAH W (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:MALEAH
Middle Name:W
Last Name:PHIPPS
Suffix:
Gender:F
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 1:16780 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:MC KENZIE
Mailing Address - State:TN
Mailing Address - Zip Code:38201-1614
Mailing Address - Country:US
Mailing Address - Phone:731-352-6180
Mailing Address - Fax:731-586-7888
Practice Address - Street 1:121 MAPLE ST
Practice Address - Street 2:
Practice Address - City:BRUCETON
Practice Address - State:TN
Practice Address - Zip Code:38317-1819
Practice Address - Country:US
Practice Address - Phone:731-586-2931
Practice Address - Fax:731-586-7888
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11253183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist