Provider Demographics
NPI:1073807095
Name:COX, TERRENCE K (RPH)
Entity Type:Individual
Prefix:
First Name:TERRENCE
Middle Name:K
Last Name:COX
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 1:895 S STATE ROAD 135
Mailing Address - Street 2:TARGET PHARMACY T-1364
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-9413
Mailing Address - Country:US
Mailing Address - Phone:317-883-5215
Mailing Address - Fax:
Practice Address - Street 1:895 S STATE ROAD 135
Practice Address - Street 2:TARGET PHARMACY T-1364
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-9413
Practice Address - Country:US
Practice Address - Phone:317-883-5215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26015140A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist