Healthcare Provider Details

I. General information

NPI: 1760573786
Provider Name (Legal Business Name): TERRILL GLENN WASHINGTON PHARM. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 IRVING ST NW # 119
WASHINGTON DC
20422-0001
US

IV. Provider business mailing address

3324 HAMPTON POINT DR APT C
SILVER SPRING MD
20904-6125
US

V. Phone/Fax

Practice location:
  • Phone: 202-745-8233
  • Fax: 202-745-8639
Mailing address:
  • Phone: 301-890-5039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH2097
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: