Provider Demographics
NPI:1104106657
Name:BELLMAN, THOMAS A (PHARMD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:A
Last Name:BELLMAN
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 1:350 WILDERNESS TRL
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43528-8073
Mailing Address - Country:US
Mailing Address - Phone:419-410-2249
Mailing Address - Fax:
Practice Address - Street 1:5200 HARROUN RD
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2168
Practice Address - Country:US
Practice Address - Phone:419-824-1089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03228014183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1053326082OtherNPI
OH3667916OtherNABP
OHBW6701367OtherDEA