Provider Demographics
NPI:1841496288
Name:HARTMAN, ENOCH JR. ELLERSON (DR PHARMACY)
Entity type:Individual
Prefix:MR
First Name:ENOCH JR.
Middle Name:ELLERSON
Last Name:HARTMAN
Suffix:
Gender:M
Credentials:DR PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 VALLEY VIEW CIRCLE
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027
Mailing Address - Country:US
Mailing Address - Phone:615-373-2760
Mailing Address - Fax:
Practice Address - Street 1:801 VALLEY VIEW CIRCLE
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027
Practice Address - Country:US
Practice Address - Phone:615-557-6629
Practice Address - Fax:615-557-6629
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNC534183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist