Provider Demographics
NPI:1346831773
Name:THAI, STEVEN WARREN (PHARMD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:WARREN
Last Name:THAI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25557 FRETTON SQ
Mailing Address - Street 2:
Mailing Address - City:SOUTH RIDING
Mailing Address - State:VA
Mailing Address - Zip Code:20152-5324
Mailing Address - Country:US
Mailing Address - Phone:703-399-1389
Mailing Address - Fax:
Practice Address - Street 1:2912 CHAIN BRIDGE RD
Practice Address - Street 2:
Practice Address - City:OAKTON
Practice Address - State:VA
Practice Address - Zip Code:22124-3001
Practice Address - Country:US
Practice Address - Phone:703-281-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202213232183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist