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General NPI Number Information
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NPI Number | 1861499378
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Entity Type | Individual
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Provider Name | THOMAS JOHN WORRALL PHARMD, BCACP
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Gender | Male
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Dates
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Enumeration Date | 06/30/2005
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Last Update Date | 11/06/2018
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Provider Practice Location Address
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Address Line | 109 BEE ST RALPH H. JOHNSON VA MEDICAL CENTER
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City | CHARLESTON
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State | SC
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Zip | 29401-5703
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Country | US
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Telephone | 843-789-6527
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Fax | 843-805-5798
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Provider Business Mailing Address
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Address Line | 800 HIGH BATTERY CIR
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City | MOUNT PLEASANT
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State | SC
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Zip | 29464-7879
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Country | US
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Telephone | 843-971-4949
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Fax | 843-805-5798
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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 | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | 009690
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License Number State | SC
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