Provider Demographics
NPI:1871185264
Name:THOMASTON PHARMACY PLLC
Entity Type:Organization
Organization Name:THOMASTON PHARMACY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:RODER-HANNA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:860-614-6563
Mailing Address - Street 1:130 S MAIN ST STE 1B
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:CT
Mailing Address - Zip Code:06787-1741
Mailing Address - Country:US
Mailing Address - Phone:860-484-4245
Mailing Address - Fax:860-288-4437
Practice Address - Street 1:130 S MAIN ST STE 1B
Practice Address - Street 2:
Practice Address - City:THOMASTON
Practice Address - State:CT
Practice Address - Zip Code:06787-1741
Practice Address - Country:US
Practice Address - Phone:860-484-4245
Practice Address - Fax:860-288-4437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-07
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy