Provider Demographics
NPI:1831979624
Name:THOMAS, ALESIA (PHARMACY TECHNICIAN)
Entity type:Individual
Prefix:
First Name:ALESIA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 BROOKLYNN ST
Mailing Address - Street 2:
Mailing Address - City:BYRAM
Mailing Address - State:MS
Mailing Address - Zip Code:39272-4517
Mailing Address - Country:US
Mailing Address - Phone:160-195-1147
Mailing Address - Fax:
Practice Address - Street 1:131 HANDLEY BLVD
Practice Address - Street 2:
Practice Address - City:BYRAM
Practice Address - State:MS
Practice Address - Zip Code:39272-8983
Practice Address - Country:US
Practice Address - Phone:769-237-4326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician