Provider Demographics
NPI:1033253950
Name:MORRIS, THOMAS OSTAVUS (RPH)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:OSTAVUS
Last Name:MORRIS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 W OAKLAND ST
Mailing Address - Street 2:P.O. BOX 887
Mailing Address - City:ANDREWS
Mailing Address - State:SC
Mailing Address - Zip Code:29510-2527
Mailing Address - Country:US
Mailing Address - Phone:843-264-3357
Mailing Address - Fax:843-264-8188
Practice Address - Street 1:13 W OAKLAND ST
Practice Address - Street 2:
Practice Address - City:ANDREWS
Practice Address - State:SC
Practice Address - Zip Code:29510-2527
Practice Address - Country:US
Practice Address - Phone:843-264-3357
Practice Address - Fax:843-264-8188
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0197140001Medicare ID - Type Unspecified