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General NPI Number Information
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NPI Number | 1780753665
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Entity Type | Individual
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Provider Name | TERRY DOUGLAS BATES RPH
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Gender | Male
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3949 N POINTE DR
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City | ZANESVILLE
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State | OH
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Zip | 43701-7361
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Country | US
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Telephone | 740-455-5555
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Fax | 740-455-2322
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Provider Business Mailing Address
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Address Line | 442 TAYLOR ST
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City | ZANESVILLE
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State | OH
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Zip | 43701-1913
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Country | US
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Telephone | 740-450-7988
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Fax |
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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 | 03-1-19074
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License Number State | OH
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