MEDICARE: MR. CHARLES E TERMINI 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	40326	MO

General Provider Information

NPI Number	:	1396736575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHARLES E TERMINI RPH

Provider Business Mailing Address
First Line	:	6414 N SPRUCE AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64119-5057
Country	:	US
Telephone Number	:	816-304-3193
Fax Number	:

Provider Business Practice Location Address
First Line	:	6414 N SPRUCE AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64119-5057
Country	:	US
Telephone Number	:	816-304-3193
Fax Number	:

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

Provider Enumeration Date	:	11/04/2005
Last Update Date	:	07/09/2007

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