Provider Demographics
NPI:1447088224
Name:THOMAS, AUSTIN BRADY (PHARMD)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:BRADY
Last Name:THOMAS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:MUSCATINE
Mailing Address - State:IA
Mailing Address - Zip Code:52761-4227
Mailing Address - Country:US
Mailing Address - Phone:563-263-1852
Mailing Address - Fax:563-263-4005
Practice Address - Street 1:510 E 6TH ST
Practice Address - Street 2:
Practice Address - City:MUSCATINE
Practice Address - State:IA
Practice Address - Zip Code:52761-4227
Practice Address - Country:US
Practice Address - Phone:563-263-1852
Practice Address - Fax:563-263-4005
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-23
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA25083183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist