MEDICARE: MR. THOMAS BERRY COLE 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	18178	NC

General Provider Information

NPI Number	:	1710361167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. THOMAS BERRY COLE PHARM.D.

Provider Business Mailing Address
First Line	:	7016 GB ALFORD HWY
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-7299
Country	:	US
Telephone Number	:	919-557-9294
Fax Number	:	919-557-1570

Provider Business Practice Location Address
First Line	:	7016 GB ALFORD HWY
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-7299
Country	:	US
Telephone Number	:	919-557-9294
Fax Number	:	919-557-1570

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

Provider Enumeration Date	:	07/15/2015
Last Update Date	:	07/15/2015

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