Provider Demographics
NPI:1194252841
Name:WELSH, TERRA (RPH)
Entity type:Individual
Prefix:
First Name:TERRA
Middle Name:
Last Name:WELSH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S HAMILTON RD
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-3308
Mailing Address - Country:US
Mailing Address - Phone:614-416-6420
Mailing Address - Fax:614-416-6422
Practice Address - Street 1:300 S HAMILTON RD
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-3308
Practice Address - Country:US
Practice Address - Phone:614-416-6420
Practice Address - Fax:614-416-6422
Is Sole Proprietor?:No
Enumeration Date:2017-05-12
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03323830183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist