Provider Demographics
NPI:1861608945
Name:PHULWANI, BHAVNA RAJESH (PHARM D)
Entity type:Individual
Prefix:MRS
First Name:BHAVNA
Middle Name:RAJESH
Last Name:PHULWANI
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:MS
Other - First Name:VANDANA
Other - Middle Name:MADHAV
Other - Last Name:RADHAKRISHNANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1920,BLACK FOX CROSSING
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37127
Mailing Address - Country:US
Mailing Address - Phone:615-867-1628
Mailing Address - Fax:
Practice Address - Street 1:806,NISSAN DRIVE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167
Practice Address - Country:US
Practice Address - Phone:615-355-7546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN25628183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist