Provider Demographics
NPI:1659539518
Name:THOMAS, JOSEPH (RPH)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:THOMAS
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 1:9798 NORTH LIMA RD
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-3230
Mailing Address - Country:US
Mailing Address - Phone:330-549-5522
Mailing Address - Fax:
Practice Address - Street 1:9798 NORTH LIMA RD
Practice Address - Street 2:
Practice Address - City:POLAND
Practice Address - State:OH
Practice Address - Zip Code:44514-3230
Practice Address - Country:US
Practice Address - Phone:330-549-5522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-28
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03213263183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0239650002Medicare NSC