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General NPI Number Information
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NPI Number | 1568114668
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Entity Type | Individual
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Provider Name | KENNETH THOMAS
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Gender | Male
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Dates
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Enumeration Date | 01/20/2022
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Last Update Date | 01/20/2022
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Provider Practice Location Address
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Address Line | 2030 FRUITVILLE PIKE
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City | LANCASTER
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State | PA
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Zip | 17601-3998
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Country | US
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Telephone | 717-581-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 219 CHAINGATE CIR
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City | LANDENBERG
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State | PA
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Zip | 19350-1307
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Country | US
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Telephone | 610-274-8635
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Fax |
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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 | RP447202
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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 | 20959
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License Number State | MD
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