Provider Demographics
NPI:1043519218
Name:TERRY, JONAS HERBERT (PHARMD, BS)
Entity Type:Individual
Prefix:DR
First Name:JONAS
Middle Name:HERBERT
Last Name:TERRY
Suffix:
Gender:M
Credentials:PHARMD, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2641 SEA SHORE DR
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-6077
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2641 SEA SHORE DR
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-6077
Practice Address - Country:US
Practice Address - Phone:504-947-6115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-26
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.018447183500000X
MD22296183500000X
VA0202212854183500000X
DCPH100001699183500000X
GARPH023996183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist