Provider Demographics
NPI:1386941342
Name:MYERS, THOMAS PRESLEY JR (RPH)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:PRESLEY
Last Name:MYERS
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4207 4TH AVE E
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35473-5117
Mailing Address - Country:US
Mailing Address - Phone:205-759-4992
Mailing Address - Fax:
Practice Address - Street 1:4200 MCFARLAND BLVD E
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405-3853
Practice Address - Country:US
Practice Address - Phone:205-759-1103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-26
Last Update Date:2011-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7472183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist