Provider Demographics
NPI:1346704517
Name:THOMPSON PHARMACY, INC.
Entity Type:Organization
Organization Name:THOMPSON PHARMACY, INC.
Other - Org Name:THOMPSON PHARMACY - INTERLOCHEN
Other - Org Type:Other Name
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-947-4212
Mailing Address - Street 1:324 S UNION ST
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-2535
Mailing Address - Country:US
Mailing Address - Phone:231-947-4212
Mailing Address - Fax:231-947-0301
Practice Address - Street 1:2072 M-137
Practice Address - Street 2:
Practice Address - City:INTERLOCHEN
Practice Address - State:MI
Practice Address - Zip Code:49643
Practice Address - Country:US
Practice Address - Phone:231-947-4212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THOMPSON PHARMACY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-22
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy