Organization
BORDEAUX LABORATORIES INC
Active
Organization
BORDEAUX LABORATORIES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONQUATIS MERRIMAN (CHIEF EXECUTIVE OFFICER)
(615) 260-0355
Entity
Organization
Contact information
Practice address
41 PEABODY ST, NASHVILLE, TN 37210-2125
(615) 260-0355
Mailing address
41 PEABODY ST, NASHVILLE, TN 37210-2125
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TH0004X
Health Psychologist
—
—
133V00000X
Registered Dietitian
—
—
133VN1004X
Pediatric Nutrition Registered Dietitian
—
—
183500000X
Pharmacist
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
2080P0205X
Pediatric Endocrinology Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
332900000X
Non-Pharmacy Dispensing Site
—
—
3336M0002X
Mail Order Pharmacy
—
—
Other
Enumeration date
07/25/2022
Last updated
08/15/2022
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