Provider Demographics
NPI:1336461698
Name:THOMPSON, JENNIFER ANN (PHARM D)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANN
Last Name:THOMPSON
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 1:5741 BUFFALO RD
Mailing Address - Street 2:
Mailing Address - City:HARBORCREEK
Mailing Address - State:PA
Mailing Address - Zip Code:16421-1626
Mailing Address - Country:US
Mailing Address - Phone:814-899-6280
Mailing Address - Fax:814-899-6265
Practice Address - Street 1:5741 BUFFALO RD
Practice Address - Street 2:
Practice Address - City:HARBORCREEK
Practice Address - State:PA
Practice Address - Zip Code:16421-1626
Practice Address - Country:US
Practice Address - Phone:814-899-6280
Practice Address - Fax:814-899-6265
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP442496183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist