Provider Demographics
NPI:1831955244
Name:CHEA, BUNNA (PHARMD)
Entity type:Individual
Prefix:
First Name:BUNNA
Middle Name:
Last Name:CHEA
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 1:4743 TRITSCHLER LN
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37128-0676
Mailing Address - Country:US
Mailing Address - Phone:978-905-9697
Mailing Address - Fax:
Practice Address - Street 1:482 INTERSTATE DR STE K
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37355-3486
Practice Address - Country:US
Practice Address - Phone:931-563-0008
Practice Address - Fax:931-954-0524
Is Sole Proprietor?:No
Enumeration Date:2024-02-23
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN47193183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist