Provider Demographics
NPI:1790008126
Name:MULLANEY, THOMAS P (RPH)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:P
Last Name:MULLANEY
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 1:6096 MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45213-1618
Mailing Address - Country:US
Mailing Address - Phone:513-587-6201
Mailing Address - Fax:513-587-7641
Practice Address - Street 1:6096 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45213-1618
Practice Address - Country:US
Practice Address - Phone:513-587-6201
Practice Address - Fax:513-587-7641
Is Sole Proprietor?:No
Enumeration Date:2010-03-12
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03318477183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist