MEDICARE: MRS. ALLISON JOY TERNES RPH

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
1	183500000X	Pharmacist	4477	ND

General Provider Information

NPI Number	:	1386993269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALLISON JOY TERNES RPH

Provider Business Mailing Address
First Line	:	323 5TH ST NE
Second Line	:	SUITE 2
City	:	DEVILS LAKE
State	:	ND
Zip	:	58301-2476
Country	:	US
Telephone Number	:	701-662-3022
Fax Number	:	701-662-2042

Provider Business Practice Location Address
First Line	:	323 5TH ST NE
Second Line	:	SUITE 2
City	:	DEVILS LAKE
State	:	ND
Zip	:	58301-2476
Country	:	US
Telephone Number	:	701-662-3022
Fax Number	:	701-662-2042

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2012
Last Update Date	:	09/06/2012

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