Provider Demographics
NPI:1487265245
Name:SAMPLES, ALEXIS (PHARMD)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:SAMPLES
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 1:624 THETFORD ALY
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-1551
Mailing Address - Country:US
Mailing Address - Phone:865-850-3158
Mailing Address - Fax:
Practice Address - Street 1:4900 PORT ROYAL RD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-2804
Practice Address - Country:US
Practice Address - Phone:931-560-2142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-13
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44279183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist