Most Relevant Information
Provider Data
| NPI Number: | 1003674433 |
| Provider Name: | HEAVEN LEE THOMAS CPHT |
| Entity Type: | Individual |
| Taxonomy Code: | 183700000X |
| Specialty: | Pharmacy Technician |
| License Number: | T23270 |
Most Important Dates
| Enumeration Date: | 03/11/2024 |
| Last Updated: | 03/11/2024 |
Provider Practice Location
16117 MCMULLEN HWY SW
CUMBERLAND
MD
215026207
Practice Location Phone/Fax
| Phone: | 3017292600 |
| Fax: | 3017291982 |
Provider Mailing Location
PO BOX 307
RAWLINGS
MD
215570307
Provider Mailing Phone/Fax
| Phone: | 2406099696 |
| Fax: |