Organization
STEVEN O THOMAS MD
Active
Organization
STEVEN O THOMAS MD
Active
Other names
EHS FIRST CARE LIBERTY LAKE
Organization subpart
No
Provider details
NPI number
Authorized official
DIRENDIA SHACKELFORD (MANAGED CARE SPECIALIST)
(800) 654-0889
Entity
Organization
Contact information
Practice address
2207 N MOLTER RD, LIBERTY LAKE, WA 99019-7570
(509) 473-5850
(509) 473-5500
Mailing address
2207 N MOLTER RD, LIBERTY LAKE, WA 99019-7570
(509) 473-5850
(509) 473-5500
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
MD00015869
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4932477
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
8114704
—
WA
Enumeration date
05/01/2007
Last updated
01/25/2010
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