Healthcare Provider Details

I. General information

NPI: 1093248981
Provider Name (Legal Business Name): THOMAS BREEDEN PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2017
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3399 POLLOCK RD
GRAND BLANC MI
48439-8395
US

IV. Provider business mailing address

1 GENESYS PKWY
GRAND BLANC MI
48439-8065
US

V. Phone/Fax

Practice location:
  • Phone: 810-606-7550
  • Fax: 810-606-6235
Mailing address:
  • Phone: 810-931-1761
  • Fax: 810-606-6235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302041223
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number5302041223
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: