Provider Demographics
NPI:1427107200
Name:BREWER, TOM N
Entity type:Individual
Prefix:MR
First Name:TOM
Middle Name:N
Last Name:BREWER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:394 CEDAR BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37398-6202
Mailing Address - Country:US
Mailing Address - Phone:931-967-6021
Mailing Address - Fax:
Practice Address - Street 1:60 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MONTEAGLE
Practice Address - State:TN
Practice Address - Zip Code:37356-3046
Practice Address - Country:US
Practice Address - Phone:931-924-2811
Practice Address - Fax:931-924-2856
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4104183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist