Provider Demographics
NPI:1396292942
Name:THOMAS, ELIZABETH (PHARMD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 PERIMETER LN
Mailing Address - Street 2:APT#202
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-5772
Mailing Address - Country:US
Mailing Address - Phone:716-481-6689
Mailing Address - Fax:
Practice Address - Street 1:195 PERIMETER LANE
Practice Address - Street 2:APT#202
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-5774
Practice Address - Country:US
Practice Address - Phone:716-481-6689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT033.0119267183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist