Provider Demographics
NPI:1467424028
Name:THOMAS, BRIDGETTE A (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:BRIDGETTE
Middle Name:A
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3511 MARYVALE RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21244-3602
Mailing Address - Country:US
Mailing Address - Phone:410-495-5525
Mailing Address - Fax:410-285-0149
Practice Address - Street 1:2400 BROENING HWY
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-6612
Practice Address - Country:US
Practice Address - Phone:410-288-8136
Practice Address - Fax:410-285-0149
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15689183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist