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General NPI Number Information
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NPI Number | 1215531900
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Entity Type | Individual
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Provider Name | THURMON JAY GAULDIN JR.
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Gender | Male
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Dates
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Enumeration Date | 11/24/2020
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Last Update Date | 11/24/2020
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Provider Practice Location Address
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Address Line | 635 CARLISLE ST
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City | HANOVER
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State | PA
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Zip | 17331-5102
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Country | US
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Telephone | 717-637-5228
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Fax | 717-637-2573
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Provider Business Mailing Address
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Address Line | 635 CARLISLE ST
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City | HANOVER
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State | PA
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Zip | 17331-5102
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Country | US
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Telephone | 717-637-5228
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Fax | 717-637-2573
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPI004975
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP045350R
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License Number State | PA
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