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NPI Code Detail

MEDICARE: DR. THOMAS STALLONS PHARM.D.

MEDICARE: DR. THOMAS STALLONS 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
1183500000XPharmacist016217KY

General Provider Information

NPI Number : 1760739593
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS STALLONS PHARM.D.
Provider Business Mailing Address
First Line : 194 REDBUD LN
Second Line :
City : GLASGOW
State : KY
Zip : 42141-8804
Country : US
Telephone Number : 270-871-9243
Fax Number :
Provider Business Practice Location Address
First Line : 1001 W MAIN ST
Second Line :
City : GLASGOW
State : KY
Zip : 42141-1119
Country : US
Telephone Number : 270-651-0471
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2012
Last Update Date : 08/10/2012

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