Provider Demographics
NPI:1710908033
Name:BIAS REALTY, LTD
Entity Type:Organization
Organization Name:BIAS REALTY, LTD
Other - Org Name:THORNE'S PHARMACY - JEFFERSON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:T
Authorized Official - Last Name:THORNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-337-9526
Mailing Address - Street 1:P.O. BOX 619, 1440 FRANKLIN AVENUE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44460
Mailing Address - Country:US
Mailing Address - Phone:330-337-9526
Mailing Address - Fax:330-337-1222
Practice Address - Street 1:344 S CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:OH
Practice Address - Zip Code:44047-1317
Practice Address - Country:US
Practice Address - Phone:440-576-6258
Practice Address - Fax:440-576-6266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH21431550333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2466415Medicaid
3672525OtherOTHER ID NUMBER-COMMERCIAL NUMBER
OH2466415Medicaid