Provider Demographics
NPI:1962993881
Name:QUICK, MALCOLM WADE JR (PHARM D)
Entity type:Individual
Prefix:DR
First Name:MALCOLM
Middle Name:WADE
Last Name:QUICK
Suffix:JR
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 WILLIAMSPORT DR
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-6357
Mailing Address - Country:US
Mailing Address - Phone:615-332-1355
Mailing Address - Fax:615-331-6118
Practice Address - Street 1:5824 NOLENSVILLE PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-6502
Practice Address - Country:US
Practice Address - Phone:615-331-2111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-25
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10017183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist