Provider Demographics
NPI:1245371368
Name:HARDESTY, PATRICK J (BSPH)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:J
Last Name:HARDESTY
Suffix:
Gender:M
Credentials:BSPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 TIMBERLINE DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-4316
Mailing Address - Country:US
Mailing Address - Phone:615-646-7155
Mailing Address - Fax:
Practice Address - Street 1:91 TIMBERLINE DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-4316
Practice Address - Country:US
Practice Address - Phone:615-646-7155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5304183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist