Thomas Edward Sullivan, R.PH.

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS25069 Issued in FL

Practice address

1010 S. Ponce Deleon Blvd
Winn-Dixie Pharmacy
St Augustine, FL 32084

Phone

(904) 825-2181

Fax

(904) 829-3643

NPI assigned

Feb 28, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215064050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1563 BARRINGTON CIR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320923619",
            "telephone_number": "904-940-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 S. PONCE DELEON BLVD",
            "address_2": "WINN-DIXIE PHARMACY",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "32084",
            "telephone_number": "904-825-2181",
            "fax_number": "904-829-3643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "THOMAS",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS25069",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "NC 8523",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "MA 15211",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Sufana
• Ava Suleiman, PMHNP-BC
• Ann Katherine Sullivan, OTR-L
• Naomi Leigh Sullivan, CNM
• Paula Jo Sullivan, LCSW
• Savannah Rose Summerford
• Kevin Marte Summerize
• Summerville at St. Augustine, LLC
• Kathryn Sumner, MS
• Sunshine Family Practice LLC

• Pharmacist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.