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Organization
ROBIN GODFREY TERRERO
Active
Organization
ROBIN GODFREY TERRERO
Active
Other names
WELLNESS STORE COMPOUNDING PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN TERRERO RPH (PIC)
(423) 476-4312
Entity
Organization
Contact information
Practice address
3555 KEITH ST NW STE 210, CLEVELAND, TN 37312-4375
(423) 476-4312
(423) 476-7982
Mailing address
3555 KEITH ST NW STE 210, CLEVELAND, TN 37312-4375
(423) 476-4312
(423) 476-7982
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
3223
TN
3336C0003X
Community/Retail Pharmacy
—
NULL
3336C0004X
Compounding Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1452909
—
TN
01
—
2092295
PK
—
Enumeration date
12/05/2005
Last updated
04/03/2013
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