Provider Demographics
NPI:1114326089
Name:ADKINS, TERRY LEE JR (PHARMD)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:LEE
Last Name:ADKINS
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 HUFFCREEK HWY
Mailing Address - Street 2:
Mailing Address - City:MAN
Mailing Address - State:WV
Mailing Address - Zip Code:25635-1039
Mailing Address - Country:US
Mailing Address - Phone:304-583-2404
Mailing Address - Fax:
Practice Address - Street 1:260 HUFFCREEK HWY
Practice Address - Street 2:
Practice Address - City:MAN
Practice Address - State:WV
Practice Address - Zip Code:25635-1039
Practice Address - Country:US
Practice Address - Phone:304-583-2404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-17
Last Update Date:2014-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0008594183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist