TERRELL LANE BOLER (NPI# 1366082893) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366082893 |
| Entity Type | Individual |
| Full Name | TERRELL LANE BOLER |
| Practice Address |
1811 W Government St Brandon MS 39042-2414 |
| Practice Telephone | 6018253773 |
| Practice Fax Number | 6015914408 |
| Mailing Telephone | 6018253773 |
| Mailing Fax Number | 6015914408 |
| Enumeration Date | 2020-01-13 |
| Last Update Date | 2020-03-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
E-010540 | MS | Pharmacy Service Providers |
| Street Address |
1811 W GOVERNMENT ST |
| City | BRANDON |
| State | MS |
| Zip Code | 39042-2414 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184658957 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 1811 W Government St, Brandon, MS 39042-2414 | 2006-07-10 |
| 1376164202 | Anney Khalid | Pharmacist | 1811 W Government St, Brandon, MS 39042-2414 | 2020-05-01 |
| 1215574363 | Kevin Hodges | Pharmacist | 1811 W Government St, Brandon, MS 39042-2414 | 2019-12-09 |
| 1144603184 | Kayla Ledford | Pharmacist | 1811 W Government St, Brandon, MS 39042-2414 | 2015-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740821529 | Claudia Francis Jones | Technician | 1008 Greenfield Circle, Brandon, MS 39042 | 2019-10-03 |
| 1194294546 | Allen Keith Johnson Jr. | Counselor | 1700 West Government Street Building B. Suite O., Brandon, MS 39042 | 2018-11-15 |
| 1689167462 | Regional Home Care and Infusions, Inc. | Registered Nurse | 302 Town Square, Suite 110, Brandon, MS 39042 | 2018-06-07 |
| 1013419563 | Brandon Family Chiropractic LLC | Chiropractor | 1350 West Government Street Suite A1, Brandon, MS 39042 | 2018-03-01 |
| 1184146789 | Lakeland Home Program LLC | Clinic/Center | 209 Mar Lyn Dr, Brandon, MS 39042 | 2017-07-14 |
| 1104275510 | Matthew Logue | Community Health Worker | 2009 Mossy Cove, Brandon, MS 39042 | 2016-06-07 |
| 1932569704 | Haley Wilson | Chiropractor | 1350 W Government St Ste A1, Brandon, MS 39042 | 2016-03-07 |
| 1548698608 | St Dominic Medical Associates LLC | Family Medicine | 1297 West Government Street, Brandon, MS 39042 | 2013-10-28 |
| 1760825434 | Linda J. Bridges | Respiratory Therapist, Certified | 330 Rankin Road, Brandon, UNITED STATES 39042 | 2013-04-12 |
| 1861739922 | Georgia Christine Shirley | Nurse Practitioner | 2008 Brookstone Place, Brandon, MS 39042 | 2013-01-09 |
| Find all providers in zip 39042 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467085274 | Kenneth Martin | Pharmacist | 1811 West Govt St, Brandon, MS 39042-2106 | 2020-02-20 |
| 1376164202 | Anney Khalid | Pharmacist | 1811 W Government St, Brandon, MS 39042-2414 | 2020-05-01 |
| 1881232304 | Michael James Still | Pharmacist | 1070 Spillway Cir, Brandon, MS 39047-6035 | 2019-12-16 |
| 1093046757 | Zirnita J Mallory | Pharmacist | 220 Grand Regency Blvd, Brandon, FL 33510-3935 | 2010-01-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316585581 | Deborah Magoun Rosenbaum | Pharmacist | [email protected], 4910 I-55 North, Jackson, MS 39211 | 2019-12-18 |
| 1326686932 | Joshua Brett Manning | Pharmacist | Kroger, 2340 Highway 15 N, Laurel, MS 39440-1831 | 2019-12-13 |
| 1023585296 | Brenda M Wise | Pharmacist | 301 Fisher St # 2b, Biloxi, MS 39534-2508 | 2018-10-25 |
| 1508311028 | Koshy Mathew | Pharmacist | 122 Mcdill Cv, Madison, MS 39110-6562 | 2016-08-25 |
| 1992106413 | Roland Mullins Jr. | Pharmacist | 301 Fisher St Rm 309b, Keesler Afb, MS 39534-2508 | 2014-09-16 |
| 1124432679 | Tara Lynn Felder | Pharmacist | 1121 Hwy 98/51, Summit, MS 39666 | 2014-06-12 |
| 1912333956 | Carman G Cochran | Pharmacist | 68 Buffalo Rd, Mc Lain, MS 39456-2330 | 2013-09-23 |
| 1902239197 | Melanie Hammill Bishop | Pharmacist | 427 Ms Highway 51 North, Brookhaven, MS 39601 | 2013-08-12 |
| 1578833299 | April Malone | Pharmacist | 208 S 27th Ave, Hattiesburg, MS 39401-7173 | 2012-01-11 |
| 1235407149 | Lorelei Lucas Farr | Pharmacist | 206 Old Corinth Rd, Petal, MS 39465-2932 | 2011-12-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.