Provider Demographics
NPI:1053520429
Name:AHRNDT, TERRY EUGENE (RPH)
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:EUGENE
Last Name:AHRNDT
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2594 ALDEN CT
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48324-2038
Mailing Address - Country:US
Mailing Address - Phone:248-363-4080
Mailing Address - Fax:
Practice Address - Street 1:2554 CROOKS RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-3352
Practice Address - Country:US
Practice Address - Phone:248-288-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302025496183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5302025496OtherPHARMACIST LICENSE NUMBER