Provider Demographics
NPI:1770882375
Name:THOMAS, AARON (RPH)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:THOMAS
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 1:116 BRENT CIR
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25271-1304
Mailing Address - Country:US
Mailing Address - Phone:304-372-2161
Mailing Address - Fax:
Practice Address - Street 1:4402 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:BIG CHIMNEY
Practice Address - State:WV
Practice Address - Zip Code:25302-4700
Practice Address - Country:US
Practice Address - Phone:304-965-7301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-22
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0004475183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist