Healthcare Provider Details

I. General information

NPI: 1740034750
Provider Name (Legal Business Name): SONIA AMIN THOMAS PHARMD, BCOP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2024
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3095 FALA PL NE
BROOKHAVEN GA
30319-2623
US

IV. Provider business mailing address

3095 FALA PL NE
BROOKHAVEN GA
30319-2623
US

V. Phone/Fax

Practice location:
  • Phone: 404-751-7414
  • Fax:
Mailing address:
  • Phone: 404-751-7414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH025699
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH025699
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License NumberRPH025699
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: