Healthcare Provider Details

I. General information

NPI: 1972103703
Provider Name (Legal Business Name): THOMAS E NORTON RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2020
Last Update Date: 10/30/2020
Certification Date: 10/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4213 ESSEX TERRACE CIR
PACE FL
32571-6354
US

IV. Provider business mailing address

WAL-MART PHARMACY 9301 PINE FOREST RD
PENSACOLA FL
32534
US

V. Phone/Fax

Practice location:
  • Phone: 870-324-0856
  • Fax:
Mailing address:
  • Phone: 850-483-6012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS20692
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: