Provider Demographics
NPI:1518296730
Name:THOMAS, COURTNEY BAREFOOT (PHARMD)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:BAREFOOT
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:887 WINE CELLAR CIR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-9298
Mailing Address - Country:US
Mailing Address - Phone:910-285-2937
Mailing Address - Fax:910-285-8550
Practice Address - Street 1:116 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WALLACE
Practice Address - State:NC
Practice Address - Zip Code:28466-2720
Practice Address - Country:US
Practice Address - Phone:910-285-2937
Practice Address - Fax:910-285-8550
Is Sole Proprietor?:No
Enumeration Date:2009-12-17
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20395183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist