Provider Demographics
NPI:1700991023
Name:ALGOOD, TERREL LEE (R PH)
Entity Type:Individual
Prefix:MR
First Name:TERREL
Middle Name:LEE
Last Name:ALGOOD
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 NORTHLAKE CIR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-2144
Mailing Address - Country:US
Mailing Address - Phone:601-364-7932
Mailing Address - Fax:601-364-7894
Practice Address - Street 1:1600 E WOODROW WILSON AVE
Practice Address - Street 2:SOUTH CENTRAL VA HEALTH CARE NETWORK (VISN 16 - 10N16)
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-5100
Practice Address - Country:US
Practice Address - Phone:601-364-7932
Practice Address - Fax:601-364-7894
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-05443183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist