Provider Demographics
NPI:1801372032
Name:SYPHER, THOMAS (RPH)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:SYPHER
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 1:16 COLLEGE HTS
Mailing Address - Street 2:
Mailing Address - City:ORONO
Mailing Address - State:ME
Mailing Address - Zip Code:04473-4233
Mailing Address - Country:US
Mailing Address - Phone:207-866-3813
Mailing Address - Fax:
Practice Address - Street 1:24 WALTON DR
Practice Address - Street 2:
Practice Address - City:BREWER
Practice Address - State:ME
Practice Address - Zip Code:04412-1001
Practice Address - Country:US
Practice Address - Phone:207-989-6174
Practice Address - Fax:207-989-6717
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202009164183500000X
MEPR4489183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist