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General NPI Number Information
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NPI Number | 1952504086
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Entity Type | Individual
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Provider Name | THOMAS GENE MCBRIDE RPH
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Gender | Male
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1823 E KIMBERLY RD
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City | DAVENPORT
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State | IA
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Zip | 52807-2027
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Country | US
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Telephone | 563-359-5313
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Fax | 563-344-8563
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Provider Business Mailing Address
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Address Line | 2538 FULTON AVE
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City | DAVENPORT
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State | IA
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Zip | 52803-3723
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Country | US
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Telephone | 563-323-7628
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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 | 14663
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License Number State | IA
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