Provider Demographics
NPI:1023340361
Name:KATAFIASZ, THOMAS ROBERT (RPH)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:ROBERT
Last Name:KATAFIASZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S BROADWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-4005
Mailing Address - Country:US
Mailing Address - Phone:785-825-2248
Mailing Address - Fax:785-825-0455
Practice Address - Street 1:400 S BROADWAY BLVD
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-4005
Practice Address - Country:US
Practice Address - Phone:785-825-2248
Practice Address - Fax:785-825-0455
Is Sole Proprietor?:No
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS9292183500000X
CA22606183500000X
AZ3736183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist