Provider Demographics
NPI:1700455144
Name:HARTZ, LABREESKA (PHARMD)
Entity Type:Individual
Prefix:
First Name:LABREESKA
Middle Name:
Last Name:HARTZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:LABREESKA
Other - Middle Name:
Other - Last Name:FRANKLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8332 HIGHWAY 104 W
Mailing Address - Street 2:
Mailing Address - City:CEDAR GROVE
Mailing Address - State:TN
Mailing Address - Zip Code:38321-7046
Mailing Address - Country:US
Mailing Address - Phone:731-234-5050
Mailing Address - Fax:
Practice Address - Street 1:8332 HIGHWAY 104 W
Practice Address - Street 2:
Practice Address - City:CEDAR GROVE
Practice Address - State:TN
Practice Address - Zip Code:38321-7046
Practice Address - Country:US
Practice Address - Phone:731-234-5050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN45220183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist