Provider Demographics
NPI:1235409376
Name:BASS, TERRY B (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:B
Last Name:BASS
Suffix:
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 1:7021 HARBOUR VIEW BLVD STE 119
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-2869
Mailing Address - Country:US
Mailing Address - Phone:757-953-4990
Mailing Address - Fax:
Practice Address - Street 1:7021 HARBOUR VIEW BLVD STE 119
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-2869
Practice Address - Country:US
Practice Address - Phone:757-953-4990
Practice Address - Fax:757-953-5030
Is Sole Proprietor?:No
Enumeration Date:2012-01-06
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202204259183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist