Healthcare Provider Details

I. General information

NPI: 1639260979
Provider Name (Legal Business Name): MONICA KAREN TERRY RPH, CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3868 HIGHWAY 431
ROANOKE AL
36274-2640
US

IV. Provider business mailing address

1013 EDGEWOOD DR
ANNISTON AL
36207-7119
US

V. Phone/Fax

Practice location:
  • Phone: 334-863-7511
  • Fax: 334-863-7500
Mailing address:
  • Phone: 256-835-1013
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11655
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number14521
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: