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General NPI Number Information
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NPI Number | 1972228914
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Entity Type | Individual
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Provider Name | FRANK A THAYER JR. RPH
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Gender | Male
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Dates
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Enumeration Date | 10/11/2022
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Last Update Date | 10/11/2022
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Provider Practice Location Address
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Address Line | 1100 PINES RD
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City | OREGON
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State | IL
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Zip | 61061-9653
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Country | US
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Telephone | 815-732-1422
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Fax |
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Provider Business Mailing Address
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Address Line | 25849 DEER RUN
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City | STERLING
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State | IL
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Zip | 61081-7800
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Country | US
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Telephone | 815-499-5647
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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 | 051040220
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License Number State | IL
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