Provider Demographics
NPI:1629647391
Name:THOMAS, GARRICK
Entity Type:Individual
Prefix:
First Name:GARRICK
Middle Name:
Last Name:THOMAS
Suffix:
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 1:569 FREEMAN MILL RD
Mailing Address - Street 2:
Mailing Address - City:HAMLET
Mailing Address - State:NC
Mailing Address - Zip Code:28345-7152
Mailing Address - Country:US
Mailing Address - Phone:910-461-8773
Mailing Address - Fax:
Practice Address - Street 1:569 FREEMAN MILL RD
Practice Address - Street 2:
Practice Address - City:HAMLET
Practice Address - State:NC
Practice Address - Zip Code:28345-7152
Practice Address - Country:US
Practice Address - Phone:910-461-8773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-17
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program