Provider Demographics
NPI:1487162285
Name:CASE, RYAN (PHARMD)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:CASE
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 1:1135 VINTA MILL RD
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:TN
Mailing Address - Zip Code:38477-6601
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1406 DONELSON PKWY
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:TN
Practice Address - Zip Code:37058-3730
Practice Address - Country:US
Practice Address - Phone:931-232-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-14
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN435331835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist