Provider Demographics
NPI:1275927782
Name:THOMAS, MATIKA (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:MATIKA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6124 HIGHWAY 72 E STE A
Mailing Address - Street 2:
Mailing Address - City:GURLEY
Mailing Address - State:AL
Mailing Address - Zip Code:35748-9423
Mailing Address - Country:US
Mailing Address - Phone:256-996-0717
Mailing Address - Fax:
Practice Address - Street 1:6124 HIGHWAY 72 E STE A
Practice Address - Street 2:
Practice Address - City:GURLEY
Practice Address - State:AL
Practice Address - Zip Code:35748-9423
Practice Address - Country:US
Practice Address - Phone:256-996-0717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-23
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL19396183500000X
ALS10766390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes183500000XPharmacy Service ProvidersPharmacist