Healthcare Provider Details

I. General information

NPI: 1528066289
Provider Name (Legal Business Name): MICHELE L THOMAS PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 BANK ST JEFFERSON BLDG., ROOM 819
RICHMOND VA
23219-3645
US

IV. Provider business mailing address

13613 WINNING COLORS LN
MIDLOTHIAN VA
23112-6188
US

V. Phone/Fax

Practice location:
  • Phone: 804-786-9489
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number0202009450
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: