Todd Gottshall, PHARM D.
Individual provider Active NPI Pharmacist · MC Kenzie, TN
NPI 1124423181 · NPPES record last updated Nov 1, 2014
Key facts
- NPI
- 1124423181
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 38376 (TN)
- Practice address
- 14860 Highland Dr
MC Kenzie, TN 38201-2606 - Phone
- (731) 352-7744
- NPI assigned
- Nov 1, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|
| 38376 | TN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Phippscare, Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 38376 | TN | Yes |
Addresses
Primary practice location
14860 Highland Dr
MC Kenzie, TN 38201-2606
Mailing address
35 Center Grove Rd
Medina, TN 38355-9626
Other providers in MC Kenzie, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2014. 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.