Provider Demographics
NPI:1639321722
Name:SZYMCZAK, THOMAS ANTHONY (RPH)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ANTHONY
Last Name:SZYMCZAK
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 1:6721 STONEGATE DR
Mailing Address - Street 2:
Mailing Address - City:TEMPERANCE
Mailing Address - State:MI
Mailing Address - Zip Code:48182-2217
Mailing Address - Country:US
Mailing Address - Phone:734-847-8101
Mailing Address - Fax:
Practice Address - Street 1:1525 CHERRY ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43608-2911
Practice Address - Country:US
Practice Address - Phone:419-255-9524
Practice Address - Fax:419-255-3177
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-10438183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist