Provider Demographics
NPI:1164973194
Name:THORPE, JACOB JAMES (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JACOB
Middle Name:JAMES
Last Name:THORPE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 COSHOCTON AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-1440
Mailing Address - Country:US
Mailing Address - Phone:740-393-9669
Mailing Address - Fax:740-399-3151
Practice Address - Street 1:1330 COSHOCTON AVE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-1440
Practice Address - Country:US
Practice Address - Phone:740-393-9669
Practice Address - Fax:740-399-3151
Is Sole Proprietor?:No
Enumeration Date:2016-10-14
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA75244183500000X
OH03233964183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist