Provider Demographics
NPI:1477667442
Name:THOMPSON & THOMPSON LONG TERM CARE INC
Entity Type:Organization
Organization Name:THOMPSON & THOMPSON LONG TERM CARE INC
Other - Org Name:DECATUR FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RPH./FOUNDER
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:319-653-1043
Mailing Address - Street 1:1010 W MADISON ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52353-1624
Mailing Address - Country:US
Mailing Address - Phone:319-653-1043
Mailing Address - Fax:888-653-1063
Practice Address - Street 1:204 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LEON
Practice Address - State:IA
Practice Address - Zip Code:50144-1450
Practice Address - Country:US
Practice Address - Phone:641-446-4136
Practice Address - Fax:641-446-6217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2013-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA14553336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2140093OtherPK