Provider Demographics
NPI:1629040548
Name:DICKINSON, TERI ANNE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:TERI
Middle Name:ANNE
Last Name:DICKINSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 CLEARFIELD LN
Mailing Address - Street 2:
Mailing Address - City:COATESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-4327
Mailing Address - Country:US
Mailing Address - Phone:610-383-9934
Mailing Address - Fax:
Practice Address - Street 1:14 S TOWER RD
Practice Address - Street 2:
Practice Address - City:NEW HOLLAND
Practice Address - State:PA
Practice Address - Zip Code:17557-1517
Practice Address - Country:US
Practice Address - Phone:717-354-4999
Practice Address - Fax:717-354-3027
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP031232L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist