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NPI Code Detail

MEDICARE: MR. TERRY ALAN GANS R.PH.

MEDICARE: MR. TERRY ALAN GANS R.PH.
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
1183500000XPharmacist26015499AIN

General Provider Information

NPI Number : 1801194360
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TERRY ALAN GANS R.PH.
Provider Business Mailing Address
First Line : 106 S COLUMBIA ST
Second Line :
City : UNION CITY
State : IN
Zip : 47390-1434
Country : US
Telephone Number : 765-964-6000
Fax Number : 765-964-6017
Provider Business Practice Location Address
First Line : 106 S COLUMBIA ST
Second Line :
City : UNION CITY
State : IN
Zip : 47390-1434
Country : US
Telephone Number : 765-964-6000
Fax Number : 765-964-6017
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2011
Last Update Date : 03/08/2011

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