Provider Demographics
NPI:1386763563
Name:CASE, TERRY WILLIAM (RPH)
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:WILLIAM
Last Name:CASE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 KINGSTON DR
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-8500
Mailing Address - Country:US
Mailing Address - Phone:502-863-4949
Mailing Address - Fax:
Practice Address - Street 1:105 SPEARS LN
Practice Address - Street 2:
Practice Address - City:CRITTENDEN
Practice Address - State:KY
Practice Address - Zip Code:41030-7513
Practice Address - Country:US
Practice Address - Phone:859-428-0900
Practice Address - Fax:859-813-1325
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY007035183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist