Provider Demographics
NPI:1487937637
Name:POPPENHEIMER, CELESTE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:CELESTE
Middle Name:
Last Name:POPPENHEIMER
Suffix:
Gender:F
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 1:8019 STONEWYCK RD
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-2349
Mailing Address - Country:US
Mailing Address - Phone:901-679-7733
Mailing Address - Fax:901-214-0010
Practice Address - Street 1:2431 N GERMANTOWN PKWY
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-4494
Practice Address - Country:US
Practice Address - Phone:901-214-0002
Practice Address - Fax:901-214-0010
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11574183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist