Provider Demographics
NPI:1760717169
Name:THORNBROUGH, MATTHEW FLOYD (PHARMD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:FLOYD
Last Name:THORNBROUGH
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 1:1101 S CROATAN HWY
Mailing Address - Street 2:
Mailing Address - City:KILL DEVIL HILLS
Mailing Address - State:NC
Mailing Address - Zip Code:27948-8708
Mailing Address - Country:US
Mailing Address - Phone:252-441-3633
Mailing Address - Fax:
Practice Address - Street 1:1101 S CROATAN HWY
Practice Address - Street 2:
Practice Address - City:KILL DEVIL HILLS
Practice Address - State:NC
Practice Address - Zip Code:27948-8708
Practice Address - Country:US
Practice Address - Phone:252-441-3633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-02
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20398183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist