Provider Demographics
NPI:1982941571
Name:JOHNSON, DENNIS NEIL (RPH)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:NEIL
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 INDIAN LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-6206
Mailing Address - Country:US
Mailing Address - Phone:615-264-2901
Mailing Address - Fax:615-264-6451
Practice Address - Street 1:110 INDIAN LAKE BLVD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-6206
Practice Address - Country:US
Practice Address - Phone:615-264-2901
Practice Address - Fax:615-264-6451
Is Sole Proprietor?:No
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000003238183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist