Healthcare Provider Details

I. General information

NPI: 1568093698
Provider Name (Legal Business Name): GEORGE TOHME RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2020
Last Update Date: 01/28/2020
Certification Date: 01/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33920 23 MILE RD
CHESTERFIELD MI
48047-4005
US

IV. Provider business mailing address

54632 ISLE ROYALE AVE
MACOMB MI
48042-2380
US

V. Phone/Fax

Practice location:
  • Phone: 586-725-3900
  • Fax: 586-725-0880
Mailing address:
  • Phone: 586-881-5842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302029150
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: