Healthcare Provider Details

I. General information

NPI: 1376716258
Provider Name (Legal Business Name): RENEE ANN TERHUNE RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2008
Last Update Date: 04/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7972 CASTOR AVE
PHILADELPHIA PA
19152-3224
US

IV. Provider business mailing address

7033 RIDGE AVE APT 4B
PHILADELPHIA PA
19128-3253
US

V. Phone/Fax

Practice location:
  • Phone: 215-728-4981
  • Fax:
Mailing address:
  • Phone: 267-972-7284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP043944L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: