Provider Demographics
NPI:1164639944
Name:MCCALL, THOMAS CECIL (RPH)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:CECIL
Last Name:MCCALL
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 1:1101 REDCOAT DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-4743
Mailing Address - Country:US
Mailing Address - Phone:704-364-9685
Mailing Address - Fax:
Practice Address - Street 1:1101 REDCOAT DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-4743
Practice Address - Country:US
Practice Address - Phone:704-364-9685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5633183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist