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NPI Code Detail

MEDICARE: MR. BRANDON L TERRY CPHT

MEDICARE: MR. BRANDON L TERRY CPHT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183700000XPharmacy Technician0230037671VA
2183700000XPharmacy TechnicianPT0010763WV

General Provider Information

NPI Number : 1134705585
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRANDON L TERRY CPHT
Provider Business Mailing Address
First Line : 152 OAK ST
Second Line :
City : JANE LEW
State : WV
Zip : 26378-6948
Country : US
Telephone Number : 681-238-8332
Fax Number :
Provider Business Practice Location Address
First Line : 200 EMILY DR
Second Line :
City : CLARKSBURG
State : WV
Zip : 26301-5500
Country : US
Telephone Number : 304-918-6056
Fax Number : 304-918-6039
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2021
Last Update Date : 08/14/2023

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Directions to “ MR. BRANDON L TERRY CPHT” Practice Location

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