MEDICARE: DR. DAVE THOMAS PHARM.D

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
1	183500000X	Pharmacist	PS41654	FL

General Provider Information

NPI Number	:	1134405756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVE THOMAS PHARM.D

Provider Business Mailing Address
First Line	:	5029 NW 41ST CT
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33319-4611
Country	:	US
Telephone Number	:	954-347-6858
Fax Number	:

Provider Business Practice Location Address
First Line	:	1005 S FEDERAL HWY
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33441-7032
Country	:	US
Telephone Number	:	954-725-1601
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2011
Last Update Date	:	12/20/2022

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