Provider Demographics
NPI:1437409059
Name:COST, TERRY W (DPH)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:W
Last Name:COST
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 SE PARKWAY
Mailing Address - Street 2:SUITE 160
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-3943
Mailing Address - Country:US
Mailing Address - Phone:615-591-1101
Mailing Address - Fax:615-591-1102
Practice Address - Street 1:145 SE PARKWAY
Practice Address - Street 2:SUITE 160
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-3943
Practice Address - Country:US
Practice Address - Phone:615-591-1101
Practice Address - Fax:615-591-1102
Is Sole Proprietor?:No
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4643183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist