Healthcare Provider Details

I. General information

NPI: 1497964043
Provider Name (Legal Business Name): KATHERINE L THOMAS RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 02/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SMH PHARMACY 400 FAIRVIEW HEIGHTS ROAD
SUMMERSVILLE WV
26651
US

IV. Provider business mailing address

SMH PHARMACY 400 FAIRVIEW HEIGHTS ROAD
SUMMERSVILLE WV
26651
US

V. Phone/Fax

Practice location:
  • Phone: 304-872-8481
  • Fax: 304-872-8468
Mailing address:
  • Phone: 304-872-8481
  • Fax: 304-872-8468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP0004563
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: