Provider Demographics
NPI:1497964043
Name:THOMAS, KATHERINE L (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:L
Last Name:THOMAS
Suffix:
Gender:F
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:SMH PHARMACY
Mailing Address - Street 2:400 FAIRVIEW HEIGHTS ROAD
Mailing Address - City:SUMMERSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26651
Mailing Address - Country:US
Mailing Address - Phone:304-872-8481
Mailing Address - Fax:304-872-8468
Practice Address - Street 1:SMH PHARMACY
Practice Address - Street 2:400 FAIRVIEW HEIGHTS ROAD
Practice Address - City:SUMMERSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26651
Practice Address - Country:US
Practice Address - Phone:304-872-8481
Practice Address - Fax:304-872-8468
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0004563183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist