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NPI Code Detail

MEDICARE: MS. TERRY HUMPHREY RPH

MEDICARE: MS. TERRY HUMPHREY RPH
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
1183500000XPharmacist191058NC

General Provider Information

NPI Number : 1427349562
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TERRY HUMPHREY RPH
Provider Business Mailing Address
First Line : 9805 ROCKY RIVER RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28215-8922
Country : US
Telephone Number : 704-494-3466
Fax Number : 704-494-2173
Provider Business Practice Location Address
First Line : 9805 ROCKY RIVER RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28215-8922
Country : US
Telephone Number : 704-494-3466
Fax Number : 704-494-2173
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2011
Last Update Date : 04/24/2011

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