Provider Demographics
NPI:1659415867
Name:CHIU, THOMAS K (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:K
Last Name:CHIU
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 W RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-1323
Mailing Address - Country:US
Mailing Address - Phone:605-338-9383
Mailing Address - Fax:605-338-1693
Practice Address - Street 1:1104 W RUSSELL ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-1323
Practice Address - Country:US
Practice Address - Phone:605-338-9383
Practice Address - Fax:605-338-1693
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD5422183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist