Provider Demographics
NPI:1982383832
Name:TERRY'S PHARMACY, INC.
Entity type:Organization
Organization Name:TERRY'S PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:RAEWYN
Authorized Official - Last Name:SNODDERLY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:423-563-7455
Mailing Address - Street 1:2715 JACKSBORO PIKE
Mailing Address - Street 2:
Mailing Address - City:JACKSBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37757-4851
Mailing Address - Country:US
Mailing Address - Phone:423-563-7455
Mailing Address - Fax:423-563-7448
Practice Address - Street 1:2715 JACKSBORO PIKE
Practice Address - Street 2:
Practice Address - City:JACKSBORO
Practice Address - State:TN
Practice Address - Zip Code:37757-4851
Practice Address - Country:US
Practice Address - Phone:423-563-7445
Practice Address - Fax:423-563-7448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy