Provider Demographics
NPI:1225181878
Name:THORNE, RICHARD (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:THORNE
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 629
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93406-0629
Mailing Address - Country:US
Mailing Address - Phone:805-544-6153
Mailing Address - Fax:805-544-6153
Practice Address - Street 1:3230 FLORA ST
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-6052
Practice Address - Country:US
Practice Address - Phone:805-544-6153
Practice Address - Fax:805-544-6153
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA307921835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy