=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326238239
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ELAINE R. THOMAS PHARM.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/26/2007
-----------------------------------------------------
Last Update Date | 07/26/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 301 YADKIN ST STANLY REGIONAL MEDICAL CENTER
-----------------------------------------------------
City | ALBEMARLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28001-3441
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-984-4686
-----------------------------------------------------
Fax | 704-983-7846
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1489 STANLY REGIONAL MEDICAL CENTER, 301 YADKIN STREET
-----------------------------------------------------
City | ALBEMARLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28002-1489
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-984-4686
-----------------------------------------------------
Fax | 704-983-7846
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 13738
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 8729
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | RPH020805
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------