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General NPI Number Information
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NPI Number | 1811391048
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Entity Type | Individual
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Provider Name | TERRI BROWN CUNNINGHAM RPH
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Gender | Female
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Dates
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Enumeration Date | 10/17/2014
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Last Update Date | 10/17/2014
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Provider Practice Location Address
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Address Line | 274 W CLINTON ST
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City | GRAY
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State | GA
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Zip | 31032-5430
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Country | US
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Telephone | 478-986-5146
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Fax |
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Provider Business Mailing Address
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Address Line | 375 CARILLON LN
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City | MACON
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State | GA
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Zip | 31210-9711
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Country | US
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Telephone | 478-719-0455
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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 | 14490
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License Number State | GA
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