Provider Demographics
NPI:1497055230
Name:GUNTHARP, THOMAS RANDALL (RPH)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:RANDALL
Last Name:GUNTHARP
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 1:1788 CHARRINGTON LN
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-7614
Mailing Address - Country:US
Mailing Address - Phone:901-239-6117
Mailing Address - Fax:
Practice Address - Street 1:4770 RIVERDALE RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38141-8529
Practice Address - Country:US
Practice Address - Phone:901-752-6263
Practice Address - Fax:901-758-3650
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11508183500000X, 1835P0018X
MS08642183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist