Provider Demographics
NPI:1952375701
Name:HOFER, THOMAS H
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:H
Last Name:HOFER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5463 KURTZ STRASZE SW
Mailing Address - Street 2:
Mailing Address - City:KALONA
Mailing Address - State:IA
Mailing Address - Zip Code:52247
Mailing Address - Country:US
Mailing Address - Phone:319-656-4588
Mailing Address - Fax:
Practice Address - Street 1:132 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH ENGLISH
Practice Address - State:IA
Practice Address - Zip Code:52316
Practice Address - Country:US
Practice Address - Phone:319-664-3115
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA12894183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist