Individual
KAVITHA THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BPHARM
Contact information
Practice address
1685 17TH AVE E, SHAKOPEE, MN 55379-4407
(952) 445-1927
(952) 253-1727
Mailing address
1685 17TH AVE E, SHAKOPEE, MN 55379-4407
(952) 445-1727
(952) 253-1727
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
117230
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
117230
PHARMACIST LICENSE
MN
Enumeration date
11/18/2015
Last updated
11/18/2015
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