Healthcare Provider Details

I. General information

NPI: 1699022442
Provider Name (Legal Business Name): GEORGE TOHME R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2012
Last Update Date: 08/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4650 N CENTRAL AVE APT 385
PHOENIX AZ
85012-1068
US

IV. Provider business mailing address

4650 N CENTRAL AVE APT 385
PHOENIX AZ
85012-1068
US

V. Phone/Fax

Practice location:
  • Phone: 602-334-8052
  • Fax:
Mailing address:
  • Phone: 602-334-8052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS021746
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number38380
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: