Provider Demographics
NPI:1871922484
Name:MORETZ, JEREMY D (PHARMD)
Entity type:Individual
Prefix:
First Name:JEREMY
Middle Name:D
Last Name:MORETZ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 MEDICAL CENTER DR
Mailing Address - Street 2:B-131 VUH
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-7610
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1211 MEDICAL CENTER DR
Practice Address - Street 2:B-131 VUH
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-7610
Practice Address - Country:US
Practice Address - Phone:828-217-3870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-04
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL512977621835P0018X
NC225551835P0018X
TN369501835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist