Provider Demographics
NPI:1184036857
Name:THOMAS, MONIQUE BEMBREY (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MONIQUE
Middle Name:BEMBREY
Last Name:THOMAS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 SW GREENVILLE BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-6908
Mailing Address - Country:US
Mailing Address - Phone:252-355-3202
Mailing Address - Fax:252-355-3202
Practice Address - Street 1:210 SW GREENVILLE BLVD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-6908
Practice Address - Country:US
Practice Address - Phone:252-355-3202
Practice Address - Fax:252-355-3202
Is Sole Proprietor?:No
Enumeration Date:2014-05-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12529183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist