Provider Demographics
NPI:1386920841
Name:PICKLE, JAMES D (RPH)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:D
Last Name:PICKLE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2421 LEBANON PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-2412
Mailing Address - Country:US
Mailing Address - Phone:615-885-4480
Mailing Address - Fax:615-885-7723
Practice Address - Street 1:2421 LEBANON PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-2412
Practice Address - Country:US
Practice Address - Phone:615-885-4480
Practice Address - Fax:615-885-7723
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-28
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4930183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist