Provider Demographics
NPI:1154319028
Name:THOMPSON & THOMPSON LONG TERM CARE INC
Entity Type:Organization
Organization Name:THOMPSON & THOMPSON LONG TERM CARE INC
Other - Org Name:SOLON DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-330-4328
Mailing Address - Street 1:411 E HAGANMAN LN
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:IA
Mailing Address - Zip Code:52333-9760
Mailing Address - Country:US
Mailing Address - Phone:319-624-4000
Mailing Address - Fax:319-624-5275
Practice Address - Street 1:411 E HAGANMAN LN
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:IA
Practice Address - Zip Code:52333-9760
Practice Address - Country:US
Practice Address - Phone:319-624-4000
Practice Address - Fax:319-624-5275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-13
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
IA12713336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1622340OtherNCPDP PROVIDER IDENTIFICATION NUMBER
IA1154319028Medicaid
1622340OtherNCPDP PROVIDER IDENTIFICATION NUMBER