Provider Demographics
NPI:1548765001
Name:TURNER, TROY (CPHT)
Entity Type:Individual
Prefix:MR
First Name:TROY
Middle Name:
Last Name:TURNER
Suffix:
Gender:M
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 BUSH ST
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-2616
Mailing Address - Country:US
Mailing Address - Phone:509-876-4250
Mailing Address - Fax:
Practice Address - Street 1:164 BUSH ST
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-2616
Practice Address - Country:US
Practice Address - Phone:509-876-4250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
5301070101399823336I0012X, 3336M0003X, 183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
No3336M0003XSuppliersPharmacyManaged Care Organization Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
530107010139982OtherPTCB PHARMACY TECHNICIAN CERTIFICATION BOARD