MEDICARE: DR. MICHELLE ELKINS THOMASON PHARMD

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	14773	AL
2	183500000X	Pharmacist	21713	GA

General Provider Information

NPI Number	:	1942525142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELLE ELKINS THOMASON PHARMD

Provider Business Mailing Address
First Line	:	1250 HIGHWAY 77
Second Line	:
City	:	SOUTHSIDE
State	:	AL
Zip	:	35907-0405
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1250 HIGHWAY 77
Second Line	:
City	:	SOUTHSIDE
State	:	AL
Zip	:	35907-0405
Country	:	US
Telephone Number	:	256-413-4473
Fax Number	:

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

Provider Enumeration Date	:	03/30/2010
Last Update Date	:	03/30/2010

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Directions to “ DR. MICHELLE ELKINS THOMASON PHARMD” Practice Location

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