Provider Demographics
NPI:1710929955
Name:O'SHEA, TERRENCE EUGENE (PHARMD, CGP)
Entity Type:Individual
Prefix:
First Name:TERRENCE
Middle Name:EUGENE
Last Name:O'SHEA
Suffix:
Gender:M
Credentials:PHARMD, CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11365 PUTNAM RD
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45322-9765
Mailing Address - Country:US
Mailing Address - Phone:937-832-1710
Mailing Address - Fax:937-836-1209
Practice Address - Street 1:600 UNION BLVD
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:OH
Practice Address - Zip Code:45322-2121
Practice Address - Country:US
Practice Address - Phone:937-771-2484
Practice Address - Fax:937-836-1209
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-16904183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist