Provider Demographics
NPI:1063895134
Name:LUPTON, THOMAS (PHARMD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:LUPTON
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 1:1550 E GUDE DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-1339
Mailing Address - Country:US
Mailing Address - Phone:816-721-5842
Mailing Address - Fax:
Practice Address - Street 1:1550 E GUDE DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-1339
Practice Address - Country:US
Practice Address - Phone:816-721-5842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-07
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MST-1011001835P0018X
KS1-164601835P0018X
NY0649871835P0018X
CA171261835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist