Provider Demographics
NPI:1578845343
Name:TRENARY, TERESA HAWN (PHARM D)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:HAWN
Last Name:TRENARY
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 1:110 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47933-1722
Mailing Address - Country:US
Mailing Address - Phone:765-361-9445
Mailing Address - Fax:765-361-5916
Practice Address - Street 1:110 W MARKET ST
Practice Address - Street 2:
Practice Address - City:CRAWFORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47933-1722
Practice Address - Country:US
Practice Address - Phone:765-361-9445
Practice Address - Fax:765-361-5916
Is Sole Proprietor?:No
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26022067A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist