Kent Dwayne Coleman
Individual provider Active NPI Pharmacist · Trenton, TN
NPI 1689368490 · NPPES record last updated Jun 5, 2023
Key facts
- NPI
- 1689368490
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5922 (TN)
- Practice address
- 319 E Eaton St
Trenton, TN 38382-1806 - Phone
- (731) 200-9050
- NPI assigned
- Jun 5, 2023
- Sex
- Male
- Sole proprietor
- Yes
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5922 | TN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coleman'S Pharmacy | Current |
Accepting new patients |
Locations
319 E Eaton St
Trenton, TN 38382
Phone (731) 200-9050
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5922 | TN | Yes |
Addresses
Primary practice location
319 E Eaton St
Trenton, TN 38382-1806
Mailing address
319 E Eaton St
Trenton, TN 38382-1806
Phone (731) 200-9050
Other providers in Trenton, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 5, 2023. 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.