Provider Demographics
NPI:1437460631
Name:MONEY, JACK (RPH)
Entity type:Individual
Prefix:MR
First Name:JACK
Middle Name:
Last Name:MONEY
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 1:5301 RINGGOLD RD
Mailing Address - Street 2:
Mailing Address - City:EAST RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37412-3125
Mailing Address - Country:US
Mailing Address - Phone:423-892-9559
Mailing Address - Fax:423-892-0614
Practice Address - Street 1:5301 RINGGOLD RD
Practice Address - Street 2:
Practice Address - City:EAST RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37412-3125
Practice Address - Country:US
Practice Address - Phone:423-892-9559
Practice Address - Fax:423-892-0614
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6017 TN183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist