Provider Demographics
NPI:1669082152
Name:DURHAM, TERESA H (RPH)
Entity type:Individual
Prefix:MS
First Name:TERESA
Middle Name:H
Last Name:DURHAM
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 1:238 AURORA LN
Mailing Address - Street 2:
Mailing Address - City:TRYON
Mailing Address - State:NC
Mailing Address - Zip Code:28782-3732
Mailing Address - Country:US
Mailing Address - Phone:828-894-4066
Mailing Address - Fax:
Practice Address - Street 1:238 AURORA LN
Practice Address - Street 2:
Practice Address - City:TRYON
Practice Address - State:NC
Practice Address - Zip Code:28782-3732
Practice Address - Country:US
Practice Address - Phone:828-894-4066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-09
Last Update Date:2020-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC009928183500000X
NC9928183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist