Basic Information
| Provider Information | |||||||||
| NPI: | 1528055878 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PIERCE | ||||||||
| FirstName: | TERESA | ||||||||
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| Credential: | RPH, CGP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12831 TOWNSHIP ROAD 108 | ||||||||
| Address2: | |||||||||
| City: | FINDLAY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458408869 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194234500 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 145 W WALLACE ST | ||||||||
| Address2: | |||||||||
| City: | FINDLAY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458401239 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194234500 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 03318389 | OH | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.