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NPI Code Detail

MEDICARE: TERRY DONMOYER TERRY

MEDICARE:   TERRY  DONMOYER  TERRY
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
1183500000XPharmacistRP030002LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15704415534OTHERPACELL PHONE

General Provider Information

NPI Number : 1427460401
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERRY DONMOYER TERRY
Provider Business Mailing Address
First Line : 101 S TULPEHOCKEN ST
Second Line :
City : PINE GROVE
State : PA
Zip : 17963-1011
Country : US
Telephone Number : 570-345-4966
Fax Number : 570-345-3927
Provider Business Practice Location Address
First Line : 101 S TULPEHOCKEN ST
Second Line :
City : PINE GROVE
State : PA
Zip : 17963-1011
Country : US
Telephone Number : 570-345-4966
Fax Number : 570-345-3927
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2014
Last Update Date : 05/27/2014

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Directions to “ TERRY DONMOYER TERRY” Practice Location

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