Provider Demographics
NPI:1215664677
Name:LEM, MACKENZIE R (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MACKENZIE
Middle Name:R
Last Name:LEM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 OAKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37207-4739
Mailing Address - Country:US
Mailing Address - Phone:724-422-3055
Mailing Address - Fax:
Practice Address - Street 1:1406 MCGAVOCK PIKE STE A
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37216-3233
Practice Address - Country:US
Practice Address - Phone:615-650-4444
Practice Address - Fax:615-650-6828
Is Sole Proprietor?:No
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN46525183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist