Provider Demographics
NPI:1508060617
Name:COYLE, TERRY LEE (RPH)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:LEE
Last Name:COYLE
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 1:507 HASTINGS WAY
Mailing Address - Street 2:
Mailing Address - City:CAMPBELLSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42718-1618
Mailing Address - Country:US
Mailing Address - Phone:270-465-3627
Mailing Address - Fax:270-789-3230
Practice Address - Street 1:950 CAMPBELLSVILLE BYP STE A
Practice Address - Street 2:R & S PULMONARY PHARMACY
Practice Address - City:CAMPBELLSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42718-7869
Practice Address - Country:US
Practice Address - Phone:270-469-1328
Practice Address - Fax:270-789-1994
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY006534183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist