Provider Demographics
NPI:1649583048
Name:THOMAS, DUSTIN NEIL (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:NEIL
Last Name:THOMAS
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 E STUART DR
Mailing Address - Street 2:
Mailing Address - City:GALAX
Mailing Address - State:VA
Mailing Address - Zip Code:24333-2124
Mailing Address - Country:US
Mailing Address - Phone:276-236-3402
Mailing Address - Fax:276-238-1426
Practice Address - Street 1:425 E STUART DR
Practice Address - Street 2:
Practice Address - City:GALAX
Practice Address - State:VA
Practice Address - Zip Code:24333-2124
Practice Address - Country:US
Practice Address - Phone:276-236-3402
Practice Address - Fax:276-238-1426
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-15
Last Update Date:2011-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202210008183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist