Provider Demographics
NPI:1538284450
Name:MCKENDRICK, THOMAS ALLEN SR (RPH)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ALLEN
Last Name:MCKENDRICK
Suffix:SR
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 1:911 CUMBERLAND DRIVE
Mailing Address - Street 2:
Mailing Address - City:WINDER
Mailing Address - State:GA
Mailing Address - Zip Code:30680
Mailing Address - Country:US
Mailing Address - Phone:404-551-2453
Mailing Address - Fax:
Practice Address - Street 1:911 CUMBERLAND ST
Practice Address - Street 2:
Practice Address - City:WINDER
Practice Address - State:GA
Practice Address - Zip Code:30680
Practice Address - Country:US
Practice Address - Phone:404-551-2453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA9888183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist