Provider Demographics
NPI:1154716702
Name:TOMLINSON, EVAN CHASE (PHARMD)
Entity type:Individual
Prefix:
First Name:EVAN
Middle Name:CHASE
Last Name:TOMLINSON
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 1:25370 RAYNAGUA BLVD
Mailing Address - Street 2:
Mailing Address - City:LOXLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36551-7552
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10179 EASTERN SHORE BLVD
Practice Address - Street 2:
Practice Address - City:SPANISH FORT
Practice Address - State:AL
Practice Address - Zip Code:36527-5801
Practice Address - Country:US
Practice Address - Phone:251-621-9771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-31
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS10825390200000X
AL19563183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program