Provider Demographics
NPI:1689802308
Name:THOMAS, GEORGE K (RPH)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:K
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 1:1575 BATHGATE AVE
Mailing Address - Street 2:AGRA PHARMACY INC
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-8216
Mailing Address - Country:US
Mailing Address - Phone:718-583-2535
Mailing Address - Fax:
Practice Address - Street 1:1575 BATHGATE AVE
Practice Address - Street 2:AGRA PHARMACY INC
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-8216
Practice Address - Country:US
Practice Address - Phone:718-583-2535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-01
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041941183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist