Provider Demographics
NPI:1407842412
Name:GREGORY, THOMAS B (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:B
Last Name:GREGORY
Suffix:
Gender:M
Credentials:PHARM D
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Mailing Address - Street 1:3801 S NATIONAL AVE
Mailing Address - Street 2:DEPARTMENT OF PHARMACY
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-5210
Mailing Address - Country:US
Mailing Address - Phone:414-225-9746
Mailing Address - Fax:417-269-5796
Practice Address - Street 1:3801 S NATIONAL AVE
Practice Address - Street 2:DEPARTMENT OF PHARMACY
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5210
Practice Address - Country:US
Practice Address - Phone:414-225-9746
Practice Address - Fax:417-269-5796
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-26
Last Update Date:2016-02-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO20040342161835P1200X, 1835P1200X
KS1-140311835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy