Provider Demographics
NPI:1134314255
Name:DANSBY, TOM (RPH)
Entity Type:Individual
Prefix:MR
First Name:TOM
Middle Name:
Last Name:DANSBY
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 1:425 PATTERSON RD
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-1953
Mailing Address - Country:US
Mailing Address - Phone:970-241-9171
Mailing Address - Fax:970-241-9140
Practice Address - Street 1:425 PATTERSON RD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-1953
Practice Address - Country:US
Practice Address - Phone:970-241-9171
Practice Address - Fax:970-241-9140
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12698183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist