Philip Andrews
Individual provider Active NPI Pharmacist · South Fulton, TN
NPI 1962421487 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1962421487
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 420 (TN)
- Practice address
- 511 Broadway St
South Fulton, TN 38257-2401 - Phone
- (731) 479-2262
- Fax
- (731) 479-5010
- NPI assigned
- Jul 18, 2006
- 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 |
|---|---|---|---|
| 420 | TN | MD | Hearing Instrument Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southside Drug Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 420 | TN | Yes |
Addresses
Primary practice location
511 Broadway St
South Fulton, TN 38257-2401
Mailing address
PO Box 5197
South Fulton, TN 38257-0197
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 54620034 | Medicaid | KY |
Other providers in South Fulton, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. 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.