Provider Demographics
NPI:1851606776
Name:RUTH, THOMAS WESLEY (PHARM D)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:WESLEY
Last Name:RUTH
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 SAINT MARY ST STE F
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-6442
Mailing Address - Country:US
Mailing Address - Phone:985-492-9200
Mailing Address - Fax:985-492-9202
Practice Address - Street 1:1615 SAINT MARY ST STE F
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-6442
Practice Address - Country:US
Practice Address - Phone:985-492-9200
Practice Address - Fax:985-492-9202
Is Sole Proprietor?:No
Enumeration Date:2010-08-16
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA17150183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist