MEDICARE: MR. THOMAS HARRISON PRICE 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
1	183500000X	Pharmacist	39473	CA

General Provider Information

NPI Number	:	1649279795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. THOMAS HARRISON PRICE RPH

Provider Business Mailing Address
First Line	:	12218 IDAHO AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-3656
Country	:	US
Telephone Number	:	310-826-3511
Fax Number	:

Provider Business Practice Location Address
First Line	:	881 ALMA REAL DR
Second Line	:
City	:	PACIFIC PALISADES
State	:	CA
Zip	:	90272-5015
Country	:	US
Telephone Number	:	310-454-6505
Fax Number	:

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

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	07/08/2007

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