Provider Demographics
NPI:1215213178
Name:SPRANKLE, TERRENCE WAYNE (RPH)
Entity Type:Individual
Prefix:MR
First Name:TERRENCE
Middle Name:WAYNE
Last Name:SPRANKLE
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 1:13 SOUTH HOLW
Mailing Address - Street 2:
Mailing Address - City:EAST HAMPTON
Mailing Address - State:CT
Mailing Address - Zip Code:06424-1511
Mailing Address - Country:US
Mailing Address - Phone:860-467-6812
Mailing Address - Fax:
Practice Address - Street 1:529 TALCOTTVILLE RD
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-2311
Practice Address - Country:US
Practice Address - Phone:860-871-6068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-24
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4388183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist