Provider Demographics
NPI:1821187501
Name:THOMAS PHARMACY INC.
Entity type:Organization
Organization Name:THOMAS PHARMACY INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-293-3128
Mailing Address - Street 1:PO BOX 39
Mailing Address - Street 2:
Mailing Address - City:KEOSAUQUA
Mailing Address - State:IA
Mailing Address - Zip Code:52565-0039
Mailing Address - Country:US
Mailing Address - Phone:319-293-3128
Mailing Address - Fax:319-293-3853
Practice Address - Street 1:601 1ST ST
Practice Address - Street 2:
Practice Address - City:KEOSAUQUA
Practice Address - State:IA
Practice Address - Zip Code:52565-7701
Practice Address - Country:US
Practice Address - Phone:319-293-3128
Practice Address - Fax:319-293-3853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336L0003X, 333600000X
IA14863336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2143587OtherPK
7170550001Medicare NSC