Provider Demographics
NPI:1417942319
Name:BYRD, TERRI PRATHER (PHARM D)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:PRATHER
Last Name:BYRD
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3003 LAKEVIEW PKWY
Mailing Address - Street 2:
Mailing Address - City:VILLA RICA
Mailing Address - State:GA
Mailing Address - Zip Code:30180-7823
Mailing Address - Country:US
Mailing Address - Phone:770-214-3738
Mailing Address - Fax:
Practice Address - Street 1:3945 LAWRENCEVILLE HWY NW
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-2817
Practice Address - Country:US
Practice Address - Phone:770-935-0061
Practice Address - Fax:770-935-0069
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH016442183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist