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NPI Code Detail

MEDICARE: JERRY M. DUREN PHARM.D.

MEDICARE: JERRY M. DUREN PHARM.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist3411TN

General Provider Information

NPI Number : 1093776049
Entity Type Code : Individual
Provider Name (Legal Business Name) : JERRY M. DUREN PHARM.D.
Provider Business Mailing Address
First Line : 215 DEXTER L WOOD MEMORIAL DR
Second Line : P. O. BOX 736
City : WAYNESBORO
State : TN
Zip : 38485-2416
Country : US
Telephone Number : 931-722-5466
Fax Number : 931-722-9495
Provider Business Practice Location Address
First Line : 215 DEXTER L WOOD MEMORIAL DR
Second Line :
City : WAYNESBORO
State : TN
Zip : 38485-2416
Country : US
Telephone Number : 931-722-5466
Fax Number : 931-722-9495
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2006
Last Update Date : 02/22/2012

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