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NPI Code Detail

MEDICARE: TERRY LYNN BILLINGSLEY R.PH.

MEDICARE: TERRY LYNN BILLINGSLEY R.PH.
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
1183500000XPharmacist10336AL

General Provider Information

NPI Number : 1356659114
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERRY LYNN BILLINGSLEY R.PH.
Provider Business Mailing Address
First Line : 6529 MOSS ROCK RDG
Second Line :
City : TRUSSVILLE
State : AL
Zip : 35173-1061
Country : US
Telephone Number : 205-655-4152
Fax Number :
Provider Business Practice Location Address
First Line : 1337 MONTCLAIR RD
Second Line :
City : IRONDALE
State : AL
Zip : 35210-2205
Country : US
Telephone Number : 205-956-0400
Fax Number : 205-951-2357
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2010
Last Update Date : 09/15/2010

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