Provider Demographics
NPI:1811297005
Name:PARISH, PATRICK NATHANIEL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:NATHANIEL
Last Name:PARISH
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 1:3619 SHIRLWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38122-4632
Mailing Address - Country:US
Mailing Address - Phone:901-568-6039
Mailing Address - Fax:
Practice Address - Street 1:9035 E SANDIDGE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:OLIVE BRANCH
Practice Address - State:MS
Practice Address - Zip Code:38654-3520
Practice Address - Country:US
Practice Address - Phone:662-892-8215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-22
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33627183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist