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NPI Code Detail

MEDICARE: THOMAS MARTIN COLONEL RPH

MEDICARE:   THOMAS MARTIN COLONEL  RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist8899NC

General Provider Information

NPI Number : 1013063874
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS MARTIN COLONEL RPH
Provider Business Mailing Address
First Line : 1040 S CHURCH ST
Second Line :
City : BURLINGTON
State : NC
Zip : 27215-5046
Country : US
Telephone Number : 336-222-8052
Fax Number : 336-222-8091
Provider Business Practice Location Address
First Line : 1040 S CHURCH ST
Second Line :
City : BURLINGTON
State : NC
Zip : 27215-5046
Country : US
Telephone Number : 336-222-8052
Fax Number : 336-222-8091
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2007
Last Update Date : 07/08/2007

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Directions to “ THOMAS MARTIN COLONEL RPH” Practice Location

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