Provider Demographics
NPI:1205856747
Name:PEIRCE, TERRY RICHARD
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:RICHARD
Last Name:PEIRCE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20495 ASH DR
Mailing Address - Street 2:
Mailing Address - City:EAGLE
Mailing Address - State:NE
Mailing Address - Zip Code:68347-2105
Mailing Address - Country:US
Mailing Address - Phone:402-781-2604
Mailing Address - Fax:
Practice Address - Street 1:600 S 70TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2451
Practice Address - Country:US
Practice Address - Phone:402-489-3802
Practice Address - Fax:402-486-7860
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8435183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist