Provider Demographics
NPI:1619717204
Name:THILO PHARMACY SERVICES LLC
Entity type:Organization
Organization Name:THILO PHARMACY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:THILO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:501-470-9898
Mailing Address - Street 1:616B HIGHWAY 365
Mailing Address - Street 2:
Mailing Address - City:MAYFLOWER
Mailing Address - State:AR
Mailing Address - Zip Code:72106-9630
Mailing Address - Country:US
Mailing Address - Phone:501-470-9898
Mailing Address - Fax:501-470-9895
Practice Address - Street 1:616B HIGHWAY 365
Practice Address - Street 2:
Practice Address - City:MAYFLOWER
Practice Address - State:AR
Practice Address - Zip Code:72106-9630
Practice Address - Country:US
Practice Address - Phone:501-470-9898
Practice Address - Fax:501-470-9895
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THILO PHARMACY SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-30
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy