=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891995437
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | THOMAS MARK HERRING II PHARMD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/23/2007
-----------------------------------------------------
Last Update Date | 07/23/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11314 US HIGHWAY 15 501 N
-----------------------------------------------------
City | CHAPEL HILL
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27517-6374
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-929-1143
-----------------------------------------------------
Fax | 919-933-2352
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 607 WELLINGHAM DR
-----------------------------------------------------
City | DURHAM
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27713-7503
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-572-1775
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 15520
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------