Provider Demographics
NPI:1922317502
Name:PRICE, THOMAS JOHN JR (PHARM, D,)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JOHN
Last Name:PRICE
Suffix:JR
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 1:3511 W PEORIA AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-4037
Mailing Address - Country:US
Mailing Address - Phone:602-866-5453
Mailing Address - Fax:602-866-5447
Practice Address - Street 1:3511 W PEORIA AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-4037
Practice Address - Country:US
Practice Address - Phone:602-866-5453
Practice Address - Fax:602-866-5447
Is Sole Proprietor?:No
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS015935183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist