Provider Demographics
NPI:1124467204
Name:HARRELL, THOMAS MAGEE (PHARM D)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:MAGEE
Last Name:HARRELL
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 13TH AVE E
Mailing Address - Street 2:T-1787
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35404-4785
Mailing Address - Country:US
Mailing Address - Phone:205-556-5731
Mailing Address - Fax:
Practice Address - Street 1:1901 13TH AVE E
Practice Address - Street 2:T-1787
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-4785
Practice Address - Country:US
Practice Address - Phone:205-556-5731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-21
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17316183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist