Provider Demographics
NPI:1649703208
Name:WARD, TERRIEKA TYESE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TERRIEKA
Middle Name:TYESE
Last Name:WARD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:TERRIEKA
Other - Middle Name:
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5402 OAKS OF ST CLAIR CIR
Mailing Address - Street 2:
Mailing Address - City:MOODY
Mailing Address - State:AL
Mailing Address - Zip Code:35004-3263
Mailing Address - Country:US
Mailing Address - Phone:205-310-6585
Mailing Address - Fax:
Practice Address - Street 1:3030 INDEPENDENCE DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-4110
Practice Address - Country:US
Practice Address - Phone:205-871-9672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-10
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA240476390200000X
AL1-131855390200000X
AL23117183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program