MEDICARE: JOSEPH THOMAS 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	03213263	OH

General Provider Information

NPI Number	:	1659539518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH THOMAS RPH

Provider Business Mailing Address
First Line	:	9798 NORTH LIMA RD
Second Line	:
City	:	POLAND
State	:	OH
Zip	:	44514-3230
Country	:	US
Telephone Number	:	330-549-5522
Fax Number	:

Provider Business Practice Location Address
First Line	:	9798 NORTH LIMA RD
Second Line	:
City	:	POLAND
State	:	OH
Zip	:	44514-3230
Country	:	US
Telephone Number	:	330-549-5522
Fax Number	:

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

Provider Enumeration Date	:	05/28/2008
Last Update Date	:	04/23/2012

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