Provider Demographics
NPI:1477137008
Name:PRZYBYL, THOMAS (RPH)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:PRZYBYL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 NORTHBROOK DR STE 1
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-1475
Mailing Address - Country:US
Mailing Address - Phone:207-781-0028
Mailing Address - Fax:207-781-0031
Practice Address - Street 1:12 NORTHBROOK DR STE 1
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1475
Practice Address - Country:US
Practice Address - Phone:207-781-0028
Practice Address - Fax:207-781-0031
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHR2720183500000X
MAPH237272183500000X
CTPCT.0014665183500000X
MEPR4379183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist