Provider Demographics
NPI:1891905949
Name:THOMAS, AMANDA JO (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:JO
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 MCGRAW RUN RD
Mailing Address - Street 2:
Mailing Address - City:SANDYVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25275-9675
Mailing Address - Country:US
Mailing Address - Phone:304-273-5825
Mailing Address - Fax:
Practice Address - Street 1:606 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:RAVENSWOOD
Practice Address - State:WV
Practice Address - Zip Code:26164-1730
Practice Address - Country:US
Practice Address - Phone:304-868-6050
Practice Address - Fax:304-868-2048
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0006786183500000X
OH03-3-26796183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist