Provider Demographics
NPI:1982907002
Name:THOMAS, BLAKE E (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BLAKE
Middle Name:E
Last Name:THOMAS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 CENTER POINT RD
Mailing Address - Street 2:
Mailing Address - City:PINSON
Mailing Address - State:AL
Mailing Address - Zip Code:35126-4209
Mailing Address - Country:US
Mailing Address - Phone:205-680-3969
Mailing Address - Fax:205-680-0935
Practice Address - Street 1:4701 CENTER POINT RD
Practice Address - Street 2:
Practice Address - City:PINSON
Practice Address - State:AL
Practice Address - Zip Code:35126-4209
Practice Address - Country:US
Practice Address - Phone:205-680-3969
Practice Address - Fax:205-680-0935
Is Sole Proprietor?:No
Enumeration Date:2010-12-11
Last Update Date:2010-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15835183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist