Provider Demographics
NPI:1033548706
Name:THOMPSON, KELSEY (PHARMD)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 PENNWOOD PL
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WARRENDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15086-6512
Mailing Address - Country:US
Mailing Address - Phone:855-779-4720
Mailing Address - Fax:855-779-4721
Practice Address - Street 1:40 PENNWOOD PL
Practice Address - Street 2:SUITE 300
Practice Address - City:WARRENDALE
Practice Address - State:PA
Practice Address - Zip Code:15086-6512
Practice Address - Country:US
Practice Address - Phone:855-779-4720
Practice Address - Fax:855-779-4721
Is Sole Proprietor?:No
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP446790183500000X
FLPS50381183500000X
KY016540183500000X
LAPST.020089183500000X
MAPH234529183500000X
MSP12786183500000X
NE14193183500000X
ORRPH-0013565183500000X
TN37194183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP446790OtherBOARD OF PHARMACY