Provider Demographics
NPI:1376826479
Name:GIACALONE, THOMAS (RPH)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:GIACALONE
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 1:10359 TIMBER STAR LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-4029
Mailing Address - Country:US
Mailing Address - Phone:702-301-2399
Mailing Address - Fax:
Practice Address - Street 1:1180 E FLAMINGO RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-3449
Practice Address - Country:US
Practice Address - Phone:702-836-9119
Practice Address - Fax:702-836-9126
Is Sole Proprietor?:No
Enumeration Date:2011-09-25
Last Update Date:2011-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV015173183500000X
NY042798183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist