Thomas M. Green, REG. PHARMACIST
Individual provider Active NPI Pharmacist · Tybee Island, GA
NPI 1760718779 · NPPES record last updated Oct 26, 2009
Key facts
- NPI
- 1760718779
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH018645 (GA)
- Practice address
- 303 1St Ave
Tybee Island, GA 31328-8752 - Phone
- (912) 786-7878
- NPI assigned
- Oct 26, 2009
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH018645 | GA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH018645 | GA | Yes |
Addresses
Primary practice location
303 1St Ave
Tybee Island, GA 31328-8752
Mailing address
303 1St Ave
Tybee Island, GA 31328-8752
Phone (912) 786-7878
Other providers in Tybee Island, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 26, 2009. 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.