Provider Demographics
NPI:1952499881
Name:THOMAS DRUG COMPANY
Entity Type:Organization
Organization Name:THOMAS DRUG COMPANY
Other - Org Name:BRUMFIELDS DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-876-3665
Mailing Address - Street 1:109 BALL AVE
Mailing Address - Street 2:
Mailing Address - City:TYLERTOWN
Mailing Address - State:MS
Mailing Address - Zip Code:39667-2101
Mailing Address - Country:US
Mailing Address - Phone:601-876-3665
Mailing Address - Fax:601-876-9922
Practice Address - Street 1:109 BALL AVE
Practice Address - Street 2:
Practice Address - City:TYLERTOWN
Practice Address - State:MS
Practice Address - Zip Code:39667-2101
Practice Address - Country:US
Practice Address - Phone:601-876-3665
Practice Address - Fax:601-876-9922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
MS01689/1.13336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Multi-Specialty
No333600000XSuppliersPharmacyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS06105814Medicaid
2144392OtherPK