Provider Demographics
NPI:1629367297
Name:ALLEN, THURMAN (RPH)
Entity Type:Individual
Prefix:
First Name:THURMAN
Middle Name:
Last Name:ALLEN
Suffix:
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 1:568 ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49068-8210
Mailing Address - Country:US
Mailing Address - Phone:269-965-3237
Mailing Address - Fax:269-965-6114
Practice Address - Street 1:568 ORCHARD RD
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MI
Practice Address - Zip Code:49068-8210
Practice Address - Country:US
Practice Address - Phone:269-965-3237
Practice Address - Fax:269-965-6114
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302020443183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist