Healthcare Provider Details

I. General information

NPI: 1447136585
Provider Name (Legal Business Name): THOMAS MCDONALD RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2025
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3471 OLD HALIFAX RD
SOUTH BOSTON VA
24592-4936
US

IV. Provider business mailing address

3471 OLD HALIFAX RD
SOUTH BOSTON VA
24592-4936
US

V. Phone/Fax

Practice location:
  • Phone: 434-575-7878
  • Fax:
Mailing address:
  • Phone: 434-222-8080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number02020005819
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: