Provider Demographics
NPI:1386238368
Name:AYELE, GERMAN T (PHARMD)
Entity type:Individual
Prefix:DR
First Name:GERMAN
Middle Name:T
Last Name:AYELE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6727 RALEIGH LAGRANGE RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38134-7017
Mailing Address - Country:US
Mailing Address - Phone:901-498-5327
Mailing Address - Fax:
Practice Address - Street 1:6727 RALEIGH LAGRANGE RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38134-7017
Practice Address - Country:US
Practice Address - Phone:901-498-5327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44181183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN44181OtherTN BOARD OF PHARMACY