Provider Demographics
NPI:1437458205
Name:LOONEY, GERALD WILLIAM (DPH)
Entity type:Individual
Prefix:
First Name:GERALD
Middle Name:WILLIAM
Last Name:LOONEY
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2490 S CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37127-5508
Mailing Address - Country:US
Mailing Address - Phone:615-867-9001
Mailing Address - Fax:615-867-9038
Practice Address - Street 1:2490 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37127-5508
Practice Address - Country:US
Practice Address - Phone:615-867-9001
Practice Address - Fax:615-867-9038
Is Sole Proprietor?:No
Enumeration Date:2011-03-19
Last Update Date:2011-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN941183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist