Provider Demographics
NPI:1619214038
Name:CASTLES, THOMAS PRESSLY JR
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:PRESSLY
Last Name:CASTLES
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 CEDAR CT EXT
Mailing Address - Street 2:
Mailing Address - City:WINNSBORO
Mailing Address - State:SC
Mailing Address - Zip Code:29180-5955
Mailing Address - Country:US
Mailing Address - Phone:803-315-4027
Mailing Address - Fax:
Practice Address - Street 1:259 CEDAR CT EXT
Practice Address - Street 2:
Practice Address - City:WINNSBORO
Practice Address - State:SC
Practice Address - Zip Code:29180-5955
Practice Address - Country:US
Practice Address - Phone:803-315-4027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-04
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4177183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC4177OtherPHARMACIST