Provider Demographics
NPI:1578570057
Name:SEIFERT, THOMAS JEFFREY (R PH)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:JEFFREY
Last Name:SEIFERT
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 TIMBERSPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3564
Mailing Address - Country:US
Mailing Address - Phone:724-349-7871
Mailing Address - Fax:
Practice Address - Street 1:841 HOSPITAL RD
Practice Address - Street 2:DIAMOND DRUGS
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3564
Practice Address - Country:US
Practice Address - Phone:724-463-3440
Practice Address - Fax:724-463-3003
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP030818L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist