Marty Gentry, PHARM D.

Individual provider Active NPI Pharmacist · Kingston Springs, TN

NPI 1487735585 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1487735585
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
11668 (TN)
Practice address
111 West Kingston Springs Road
Suite 103
Kingston Springs, TN 37082
Phone
(615) 952-3690
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
Yes

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
11668TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Pharmacy Care Inc Past Accepting new patients
Eyes on Diabetes PLLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 11668 TN Yes

Addresses

Primary practice location

111 West Kingston Springs Road
Suite 103
Kingston Springs, TN 37082

Mailing address

1209 Shelby Ave
Nashville, TN 37206-3031

Other providers in Kingston Springs, TN

All providers in Kingston Springs, TN · Pharmacist in Tennessee

Sources for this page

Verify at the official NPI Registry.