Michael Kevin Tomb, RPH
Individual provider Active NPI Pharmacist · Jackson, LA
NPI 1346353091 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1346353091
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 13993 (LA)
- Practice address
- 1701 Charter St
Jackson, LA 70748 - Phone
- (225) 634-2470
- Fax
- (225) 634-7975
- NPI assigned
- Aug 16, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13993 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| R.C.McDonald Co Inc | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 13993 | LA | Yes |
Addresses
Primary practice location
1701 Charter St
Jackson, LA 70748
Mailing address
PO Box 306
Jackson, LA 70748-0306
Phone (225) 634-2470
Other providers in Jackson, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.