Provider Demographics
NPI:1346991908
Name:THOMAS, AMBER DARCHE
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:DARCHE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 WESTRIDGE PKWY
Mailing Address - Street 2:STE 714 PMB 1215
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253
Mailing Address - Country:US
Mailing Address - Phone:855-475-8783
Mailing Address - Fax:866-502-3626
Practice Address - Street 1:600 WESTRIDGE PKWY
Practice Address - Street 2:STE 714 PMB 1215
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253
Practice Address - Country:US
Practice Address - Phone:855-475-8783
Practice Address - Fax:866-502-3626
Is Sole Proprietor?:No
Enumeration Date:2022-01-15
Last Update Date:2022-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy