Healthcare Provider Details

I. General information

NPI: 1245922962
Provider Name (Legal Business Name): TERI J SYKES PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2023
Last Update Date: 05/22/2023
Certification Date: 05/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2940 S 109TH ST
TOLEDO OH
43611-2823
US

IV. Provider business mailing address

2940 S 109TH ST
TOLEDO OH
43611-2823
US

V. Phone/Fax

Practice location:
  • Phone: 419-346-4779
  • Fax:
Mailing address:
  • Phone: 419-346-4779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03223548
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: