Provider Demographics
NPI:1255928610
Name:THOMAS, EMILEE JESSICA (PHARMD)
Entity type:Individual
Prefix:
First Name:EMILEE
Middle Name:JESSICA
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 1:2325 E RIO SALADO PKWY APT 2001
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-7476
Mailing Address - Country:US
Mailing Address - Phone:585-802-5517
Mailing Address - Fax:
Practice Address - Street 1:1245 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-7018
Practice Address - Country:US
Practice Address - Phone:480-833-8879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-30
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS024993183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist