Nathaniel Graham Norman, PHARMD
Individual provider Active NPI Pharmacist · East Ridge, TN
NPI 1124339965 · NPPES record last updated Oct 17, 2011
Key facts
- NPI
- 1124339965
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 0000029429 (TN)
- Practice address
- 3508 Ringgold Rd
East Ridge, TN 37412-1208 - Phone
- (423) 624-6584
- Fax
- (423) 624-1981
- NPI assigned
- Jun 26, 2010
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000029429 | TN | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0000029429 | TN | Yes |
Addresses
Primary practice location
3508 Ringgold Rd
East Ridge, TN 37412-1208
Mailing address
5478 Highway 153
Hixson, TN 37343-3782
Phone (423) 875-0855
Other providers in East Ridge, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.