Provider Demographics
NPI:1700173341
Name:THOMAS, ROXANNE PASCOE (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:ROXANNE
Middle Name:PASCOE
Last Name:THOMAS
Suffix:
Gender:F
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 1:5100 E HIGHWAY 100
Mailing Address - Street 2:T-2364
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-2365
Mailing Address - Country:US
Mailing Address - Phone:386-313-3952
Mailing Address - Fax:
Practice Address - Street 1:5100 E HIGHWAY 100
Practice Address - Street 2:T-2364
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-2365
Practice Address - Country:US
Practice Address - Phone:386-313-3952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-04
Last Update Date:2011-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS41237183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist