Provider Demographics
NPI:1750571246
Name:SANDERS, JEREMY LEE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:LEE
Last Name:SANDERS
Suffix:
Gender:M
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 1:1100 NEW SMITHVILLE HWY SUITE 114
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37110
Mailing Address - Country:US
Mailing Address - Phone:931-473-3183
Mailing Address - Fax:931-473-6813
Practice Address - Street 1:1100 NEW SMITHVILLE HWY SUITE 114
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110
Practice Address - Country:US
Practice Address - Phone:931-473-3183
Practice Address - Fax:931-473-6813
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000029487183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist