Provider Demographics
NPI:1144580952
Name:ARNES, THOMAS LAURITZ (RPH)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:LAURITZ
Last Name:ARNES
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 1:4165 E COURT ST
Mailing Address - Street 2:
Mailing Address - City:BURTON
Mailing Address - State:MI
Mailing Address - Zip Code:48509-1717
Mailing Address - Country:US
Mailing Address - Phone:810-742-8423
Mailing Address - Fax:810-742-3900
Practice Address - Street 1:4165 E COURT ST
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48509-1717
Practice Address - Country:US
Practice Address - Phone:810-742-8423
Practice Address - Fax:810-742-3900
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302411024183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist