Organization
TENNESSEE ONCOLOGY PHARMACY DISPENSING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATTIE DOUGLAS (PAYER RELATIONS MANAGER)
(615) 514-3042
Entity
Organization
Contact information
Practice address
1750 CEDAR LN, STE 200, TULLAHOMA, TN 37388-4759
(931) 393-3143
Mailing address
PO BOX 440553, NASHVILLE, TN 37244-0553
(615) 329-0570
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
26292
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3709319
—
TN
Enumeration date
02/02/2011
Last updated
06/13/2017
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