Provider Demographics
NPI:1366159717
Name:THOMAS, HALEY EMMA (PHARMD)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:EMMA
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 1:184 W KYTLE ST STE A
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:GA
Mailing Address - Zip Code:30528-9607
Mailing Address - Country:US
Mailing Address - Phone:706-219-2626
Mailing Address - Fax:
Practice Address - Street 1:184 W KYTLE ST STE A
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:GA
Practice Address - Zip Code:30528-9607
Practice Address - Country:US
Practice Address - Phone:706-219-2626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH033131183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist