Provider Demographics
NPI:1508933714
Name:NEUMAYR, THOMAS HERMAN (RPH)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:HERMAN
Last Name:NEUMAYR
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:PO BOX 430
Mailing Address - Street 2:
Mailing Address - City:PARKSTON
Mailing Address - State:SD
Mailing Address - Zip Code:57366-0430
Mailing Address - Country:US
Mailing Address - Phone:605-928-3125
Mailing Address - Fax:605-928-7516
Practice Address - Street 1:112 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PARKSTON
Practice Address - State:SD
Practice Address - Zip Code:57366-0430
Practice Address - Country:US
Practice Address - Phone:605-928-3125
Practice Address - Fax:605-928-7516
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD8500330Medicaid
SD9162860Medicaid
SD8500330Medicaid