Provider Demographics
NPI:1497338917
Name:THOMAS, JARED PEYTON (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:PEYTON
Last Name:THOMAS
Suffix:
Gender:M
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 E BAY ST STE 304
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29401-2636
Mailing Address - Country:US
Mailing Address - Phone:843-853-6999
Mailing Address - Fax:
Practice Address - Street 1:215 E BAY ST STE 304
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-2636
Practice Address - Country:US
Practice Address - Phone:843-853-6999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-03
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician