Provider Demographics
NPI:1992920250
Name:COUTO, THOMAS J (RPH)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:J
Last Name:COUTO
Suffix:
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 1:7 HERITAGE LN
Mailing Address - Street 2:
Mailing Address - City:MATTAPOISETT
Mailing Address - State:MA
Mailing Address - Zip Code:02739-1120
Mailing Address - Country:US
Mailing Address - Phone:508-758-2315
Mailing Address - Fax:
Practice Address - Street 1:233 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-5306
Practice Address - Country:US
Practice Address - Phone:508-679-1838
Practice Address - Fax:508-674-5610
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21099183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist