Provider Demographics
NPI:1083936843
Name:THOMAS, THOMAS CRAIG (RPH)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:CRAIG
Last Name:THOMAS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1841 RABBIT WARREN RD
Mailing Address - Street 2:
Mailing Address - City:MANAKIN SABOT
Mailing Address - State:VA
Mailing Address - Zip Code:23103-2149
Mailing Address - Country:US
Mailing Address - Phone:804-784-2690
Mailing Address - Fax:804-674-7427
Practice Address - Street 1:10003 HULL STREET ROAD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113
Practice Address - Country:US
Practice Address - Phone:804-674-5291
Practice Address - Fax:804-674-7427
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202001829183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist