MEDICARE: DR. SOPHIA HONDROS THOMOPOULOS 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	17681	NC

General Provider Information

NPI Number	:	1942535794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SOPHIA HONDROS THOMOPOULOS PHARM D

Provider Business Mailing Address
First Line	:	1235 EAST BLVD STE J
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28203-5876
Country	:	US
Telephone Number	:	704-910-4288
Fax Number	:	704-910-4294

Provider Business Practice Location Address
First Line	:	1235 EAST BLVD STE J
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28203-5876
Country	:	US
Telephone Number	:	704-910-4288
Fax Number	:	704-910-4294

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

Provider Enumeration Date	:	10/13/2009
Last Update Date	:	10/13/2009

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