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NPI Code Detail

MEDICARE: ROBIN GODFREY TERRERO

MEDICARE: ROBIN GODFREY TERRERO
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
13336C0004XCompounding Pharmacy
23336C0003XCommunity/Retail Pharmacy
3333600000XPharmacy3223TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12092295OTHERPK
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518941392
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROBIN GODFREY TERRERO
Provider Business Mailing Address
First Line : 3555 KEITH ST NW STE 210
Second Line :
City : CLEVELAND
State : TN
Zip : 37312-4375
Country : US
Telephone Number : 423-476-4312
Fax Number : 423-476-7982
Provider Business Practice Location Address
First Line : 3555 KEITH ST NW STE 210
Second Line :
City : CLEVELAND
State : TN
Zip : 37312-4375
Country : US
Telephone Number : 423-476-4312
Fax Number : 423-476-7982
Authorized Official
Title or Position : PIC
Name : ROBIN TERRERO
Credential : RPH
Telephone Number : 423-476-4312
Provider Enumeration Date : 12/05/2005
Last Update Date : 04/03/2013

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Directions to “ROBIN GODFREY TERRERO ” Practice Location

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