Corey D Grimshaw, PHARMD
Individual provider Active NPI Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Fairview, TN
NPI 1669019188 · NPPES record last updated Dec 3, 2019
Key facts
- NPI
- 1669019188
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
- License
- 40224 (TN)
- Practice address
- Tucker Pharmacy
2415 Fairview Blvd
Fairview, TN 37062-3706 - Phone
- (615) 799-0691
- NPI assigned
- Dec 3, 2019
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|
| 019917 | KY | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| 0202217951 | VA | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| 40224 | TN | MD | Psychiatry Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 019917 | KY | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 0202217951 | VA | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 40224 | TN | Yes |
Addresses
Primary practice location
Tucker Pharmacy
2415 Fairview Blvd
Fairview, TN 37062-3706
Mailing address
515 Madison St Apt 414
Nashville, TN 37208-1686
Phone (865) 804-3790
Other providers in Fairview, TN
- Tina Franco
- Freds Stores of Tennessee Inc
- Freds Stores of Tennessee Inc
- Maritza Garcia-Williams
- Christine Golla
- Matthew Alex Hacker
- Haralambis Enterprises LLC
- Sean Carlos Harding
- William Isaac Harper
- Frances Elaine Hibbs
All providers in Fairview, TN · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2019. 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.