Provider Demographics
NPI:1538513320
Name:THOMAS, TERESA ANNE (BPHARM)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:ANNE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:BPHARM
Other - Prefix:
Other - First Name:TERI
Other - Middle Name:ANNE
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:21 WEDGEWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:PA
Mailing Address - Zip Code:18612-9198
Mailing Address - Country:US
Mailing Address - Phone:570-430-2618
Mailing Address - Fax:
Practice Address - Street 1:531 MT PLEASANT DR
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18503-1987
Practice Address - Country:US
Practice Address - Phone:570-703-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-18
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP042288L1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy