Provider Demographics
NPI:1114276656
Name:THOMPSON, MARJORIE S (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MARJORIE
Middle Name:S
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ROUTE 70 AND CHAMBERSBRIDGE ROAD
Mailing Address - Street 2:BRICKTOWN SHOPRITE
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723
Mailing Address - Country:US
Mailing Address - Phone:732-477-6733
Mailing Address - Fax:
Practice Address - Street 1:ROUTE 70 AND CHAMBERSBRIDGE ROAD
Practice Address - Street 2:BRICKTOWN SHOPRITE
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723
Practice Address - Country:US
Practice Address - Phone:732-477-6733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI015708001835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric