=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497766836
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TERRI ANGELA STORMS PHARMD, RPH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/10/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5106 HWY 87 SOUTH, STE100
-----------------------------------------------------
City | FAYETTEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28306
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-483-3466
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5106 HWY 87 SOUTH, STE100
-----------------------------------------------------
City | FAYETTEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28306
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-483-3466
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 13989
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------