Healthcare Provider Details

I. General information

NPI: 1861791642
Provider Name (Legal Business Name): THOMAS TERRY HURST B.S.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2011
Last Update Date: 03/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 QUINTARD AVE
ANNISTON AL
36201-3845
US

IV. Provider business mailing address

1430 QUINTARD AVE
ANNISTON AL
36201-3845
US

V. Phone/Fax

Practice location:
  • Phone: 256-237-0759
  • Fax: 256-237-3023
Mailing address:
  • Phone: 256-237-0759
  • Fax: 256-237-3023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number16033
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberE06356
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: