Provider Demographics
NPI:1508983800
Name:THOMAS, SANDRA ANN (RPH)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:ANN
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 1:945 EFFIE ROAD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40511-2260
Mailing Address - Country:US
Mailing Address - Phone:859-253-0125
Mailing Address - Fax:859-253-0125
Practice Address - Street 1:401 WEST MAIN STREET
Practice Address - Street 2:HUTCHINSON DRUGSTORE
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40507
Practice Address - Country:US
Practice Address - Phone:859-252-3554
Practice Address - Fax:859-252-3555
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY7069183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist