Healthcare Provider Details

I. General information

NPI: 1588764559
Provider Name (Legal Business Name): P THOMAS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 01/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27449 ANDREW JACKSON HWY E
DELCO NC
28436-8822
US

IV. Provider business mailing address

27449 ANDREW JACKSON HWY E
DELCO NC
28436-8822
US

V. Phone/Fax

Practice location:
  • Phone: 910-655-2667
  • Fax: 910-655-2094
Mailing address:
  • Phone: 910-655-2667
  • Fax: 910-655-2094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number05117
License Number StateNC

VIII. Authorized Official

Name: JOHN THOMAS
Title or Position: OWNER
Credential: RPH
Phone: 910-655-2667