Provider Demographics
NPI:1275201667
Name:THIGPEN, CHUN AE (PHARM D)
Entity Type:Individual
Prefix:
First Name:CHUN AE
Middle Name:
Last Name:THIGPEN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2233 WHITE WAY
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35226-3125
Mailing Address - Country:US
Mailing Address - Phone:205-335-1205
Mailing Address - Fax:
Practice Address - Street 1:2233 WHITE WAY
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35226-3125
Practice Address - Country:US
Practice Address - Phone:205-335-1205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL590141835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL8895Medicaid