Provider Demographics
NPI:1053608158
Name:BATES, CATHERINE BLACK (PHARM D)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:BLACK
Last Name:BATES
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:A
Other - Last Name:BLACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:3880 DICKERSON PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37207
Mailing Address - Country:US
Mailing Address - Phone:615-868-5633
Mailing Address - Fax:615-868-9015
Practice Address - Street 1:3880 DICKERSON PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207
Practice Address - Country:US
Practice Address - Phone:615-868-5633
Practice Address - Fax:615-868-9015
Is Sole Proprietor?:No
Enumeration Date:2011-07-09
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN36479183500000X
MSP11711183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist