MEDICARE: DR. TERRI DART PHARMD

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	PD08598	AR

General Provider Information

NPI Number	:	1477153690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TERRI DART PHARMD

Provider Business Mailing Address
First Line	:	5322 HIGHWAY 282
Second Line	:
City	:	RUDY
State	:	AR
Zip	:	72952-9011
Country	:	US
Telephone Number	:	479-461-3033
Fax Number	:

Provider Business Practice Location Address
First Line	:	2425 S ZERO ST
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72901-8663
Country	:	US
Telephone Number	:	479-646-4983
Fax Number	:

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

Provider Enumeration Date	:	10/27/2020
Last Update Date	:	10/27/2020

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Directions to “ DR. TERRI DART PHARMD” Practice Location

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