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General NPI Number Information
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NPI Number | 1841334307
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Entity Type | Individual
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Provider Name | CHARLES THOMAS RPH
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Gender | Male
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Dates
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Enumeration Date | 02/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 556 ELBERT ST
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City | ELBERTON
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State | GA
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Zip | 30635-2347
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Country | US
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Telephone | 706-283-3161
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Fax | 706-283-3728
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Provider Business Mailing Address
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Address Line | PO BOX 82
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City | ELBERTON
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State | GA
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Zip | 30635-0082
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Country | US
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Telephone | 706-283-7273
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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 | RPH010894
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License Number State | GA
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