Provider Demographics
NPI:1780800706
Name:THOMAS, JACQUELINE K (RPH)
Entity type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:K
Last Name:THOMAS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1707 JANUARY DR
Mailing Address - Street 2:#302
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-6916
Mailing Address - Country:US
Mailing Address - Phone:301-244-5306
Mailing Address - Fax:
Practice Address - Street 1:1101 WOOTTON PKWY
Practice Address - Street 2:PLAZA LEVEL SUITE 100
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1059
Practice Address - Country:US
Practice Address - Phone:240-453-6008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA16673183500000X
TX37962183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist