Provider Demographics
NPI:1538405634
Name:PARKHURST, TIFFANY (PHARMD)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:PARKHURST
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 1:3685 S HOUSTON LEVEE RD
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-9014
Mailing Address - Country:US
Mailing Address - Phone:901-854-2707
Mailing Address - Fax:901-854-2710
Practice Address - Street 1:3685 S HOUSTON LEVEE RD
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-9014
Practice Address - Country:US
Practice Address - Phone:901-854-2707
Practice Address - Fax:901-854-2710
Is Sole Proprietor?:No
Enumeration Date:2012-12-17
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11247183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist