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General NPI Number Information
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NPI Number | 1073927174
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Entity Type | Individual
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Provider Name | TERIONE M BROCK PHARMD
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Gender | Female
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Dates
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Enumeration Date | 06/17/2014
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Last Update Date | 07/24/2021
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Provider Practice Location Address
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Address Line | 6721 ST. CLAUDE AVENUE SUITE A
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City | ARABI
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State | LA
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Zip | 70032
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Country | US
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Telephone | 504-324-9229
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Fax | 504-302-9228
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Provider Business Mailing Address
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Address Line | 6721 SAINT CLAUDE AVE STE A
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City | ARABI
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State | LA
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Zip | 70032-1247
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Country | US
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Telephone | 504-324-9229
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Fax | 504-302-9229
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 17211
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 13820
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 020712
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License Number State | LA
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