Provider Demographics
NPI:1316364078
Name:AYERS, THOMAS W (RPH)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:W
Last Name:AYERS
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 1:1612 SOUTHWOOD CT
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-3195
Mailing Address - Country:US
Mailing Address - Phone:843-229-0184
Mailing Address - Fax:843-774-7172
Practice Address - Street 1:1210 HIGHWAY 301 N
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:SC
Practice Address - Zip Code:29536-2455
Practice Address - Country:US
Practice Address - Phone:843-774-2707
Practice Address - Fax:843-774-7172
Is Sole Proprietor?:No
Enumeration Date:2014-03-19
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9717183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist