Provider Demographics
NPI:1467594309
Name:WERNETTE, TERRENCE LEE (RPH)
Entity Type:Individual
Prefix:MR
First Name:TERRENCE
Middle Name:LEE
Last Name:WERNETTE
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 1:711 W ARDUSSI ST
Mailing Address - Street 2:
Mailing Address - City:FRANKENMUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48734-1409
Mailing Address - Country:US
Mailing Address - Phone:989-652-9178
Mailing Address - Fax:
Practice Address - Street 1:1447 N. HARRISON
Practice Address - Street 2:COVENANT HEALTHCARE
Practice Address - City:SAGIANW
Practice Address - State:MI
Practice Address - Zip Code:48602
Practice Address - Country:US
Practice Address - Phone:989-583-4075
Practice Address - Fax:989-583-4819
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI25193183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist