Jerry Benson Bryant, DPH

Individual provider Active NPI Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Pulaski, TN

NPI 1013299718 · NPPES record last updated Sep 19, 2011

Key facts

NPI
1013299718
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
License
3916 (TN)
Practice address
620 W College St
Pulaski, TN 38478-3613
Phone
(931) 424-5335
Fax
(931) 424-6463
NPI assigned
Sep 19, 2011
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 3916 TN Yes

Addresses

Primary practice location

620 W College St
Pulaski, TN 38478-3613

Mailing address

620 W College St
Pulaski, TN 38478-3613
Phone (931) 424-5335

Other providers in Pulaski, TN

All providers in Pulaski, TN · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Tennessee

Sources for this page

Verify at the official NPI Registry.