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General NPI Number Information
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NPI Number | 1679891162
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Entity Type | Individual
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Provider Name | THOMAS WILLIAM CUNNINGHAM RPH
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Gender | Male
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Dates
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Enumeration Date | 05/10/2010
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Last Update Date | 05/10/2010
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Provider Practice Location Address
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Address Line | 1123 PEARL ST
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City | BROCKTON
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State | MA
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Zip | 02301-5406
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Country | US
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Telephone | 508-588-4600
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Fax |
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Provider Business Mailing Address
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Address Line | 51 DIANE TERR
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City | WHITMAN
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State | MA
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Zip | 02382
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Country | US
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Telephone | 781-447-2644
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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 | PH 15476
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License Number State | MA
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