Provider Demographics
NPI:1942671821
Name:MYRICK, JAMES RANDALL (PHARMD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:RANDALL
Last Name:MYRICK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6848 SONYA DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-5224
Mailing Address - Country:US
Mailing Address - Phone:615-934-5275
Mailing Address - Fax:
Practice Address - Street 1:3171 LEBANON PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-2314
Practice Address - Country:US
Practice Address - Phone:615-889-4734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-16
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8892183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist