MEDICARE: THOMAS ASHBAKER

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	15216	AL
2	183500000X	Pharmacist	12807	MS

General Provider Information

NPI Number	:	1578800629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS ASHBAKER

Provider Business Mailing Address
First Line	:	411 GREEN SPRINGS HWY
Second Line	:
City	:	HOMEWOOD
State	:	AL
Zip	:	35209-4909
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	411 GREEN SPRINGS HWY
Second Line	:
City	:	HOMEWOOD
State	:	AL
Zip	:	35209-4909
Country	:	US
Telephone Number	:	205-944-1112
Fax Number	:

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

Provider Enumeration Date	:	01/09/2013
Last Update Date	:	03/20/2013

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Directions to “ THOMAS ASHBAKER ” Practice Location

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