Provider Demographics
NPI:1346445988
Name:STURM, THOMAS ALBIN (RPH)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ALBIN
Last Name:STURM
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:56 EVERGREEN DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05462-6220
Mailing Address - Country:US
Mailing Address - Phone:802-434-8484
Mailing Address - Fax:
Practice Address - Street 1:820 STOWE WATERBURY RD
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:VT
Practice Address - Zip Code:05671-0001
Practice Address - Country:US
Practice Address - Phone:802-241-4115
Practice Address - Fax:802-244-7994
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT033-00037161835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO11890OtherPHARMACY LICENSE