Provider Demographics
NPI:1285386037
Name:MOSES-TOLBERT, DAINER (PHARMD)
Entity type:Individual
Prefix:
First Name:DAINER
Middle Name:
Last Name:MOSES-TOLBERT
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:ONE HUNDRED OAKS, 719 THOMPSON LANE
Mailing Address - Street 2:SUITE 24130
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:ONE HUNDRED OAKS, 719 THOMPSON LANE
Practice Address - Street 2:SUITE 24130
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204
Practice Address - Country:US
Practice Address - Phone:615-322-5353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-24
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18662183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist