Individual
JERRY P. ELEDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPH
Contact information
Practice address
5150 MURFREESBORO RD # A, LA VERGNE, TN 37086-2712
(615) 213-1203
(615) 213-1530
Mailing address
PO BOX 92, BRENTWOOD, TN 37024-0092
(615) 213-1203
(615) 213-1530
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8052
TN
Other
Enumeration date
03/30/2007
Last updated
07/08/2007
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