1891859690 NPI number — UW STUDENT HEALTH SERVICE PHARMACY

Table of content: MR. TERRY LEE MASHBURN LPC (NPI 1033366117)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891859690 NPI number — UW STUDENT HEALTH SERVICE PHARMACY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UW STUDENT HEALTH SERVICE PHARMACY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891859690
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1000 E UNIVERSITY AVE
Provider Second Line Business Mailing Address:
DEPT 3068
Provider Business Mailing Address City Name:
LARAMIE
Provider Business Mailing Address State Name:
WY
Provider Business Mailing Address Postal Code:
82071-2000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
307-766-2130
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 E UNIVERSITY AVE
Provider Second Line Business Practice Location Address:
DEPT 3068
Provider Business Practice Location Address City Name:
LARAMIE
Provider Business Practice Location Address State Name:
WY
Provider Business Practice Location Address Postal Code:
82071-2000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
307-766-2130
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
STEANE
Authorized Official First Name:
JOANNE
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
307-766-2130

Provider Taxonomy Codes

  • Taxonomy code: 333600000X , with the licence number:  5200605 , registered in the state of WY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com