Provider Demographics
NPI:1003857228
Name:THOMPSON ENTERPRISES, INC.
Entity Type:Organization
Organization Name:THOMPSON ENTERPRISES, INC.
Other - Org Name:THOMPSON PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:DONNELLY
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:III
Authorized Official - Credentials:RPH
Authorized Official - Phone:814-944-6139
Mailing Address - Street 1:600 E CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-5216
Mailing Address - Country:US
Mailing Address - Phone:814-944-6139
Mailing Address - Fax:814-942-1052
Practice Address - Street 1:602 E CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-5216
Practice Address - Country:US
Practice Address - Phone:814-944-6139
Practice Address - Fax:814-942-1052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP412570L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007648870002Medicaid
PA1007648870002Medicaid