1801043153 NPI number — DR. EVANS THOMAS PRIESTON PHARM.D.

Table of content: DR. EVANS THOMAS PRIESTON PHARM.D. (NPI 1801043153)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801043153 NPI number — DR. EVANS THOMAS PRIESTON PHARM.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PRIESTON
Provider First Name:
EVANS
Provider Middle Name:
THOMAS
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARM.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801043153
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/19/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
112 NORTH SEVENTH ST.
Provider Second Line Business Mailing Address:
CHAMBERSBURG HOSPITAL PHARMACY.
Provider Business Mailing Address City Name:
CHAMBERSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-267-7441
Provider Business Mailing Address Fax Number:
717-267-4812

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
263 WESTOVER WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHAMBERSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17202-4458
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-264-5345
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/19/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  RP28601L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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