Provider Demographics
NPI:1619758844
Name:THOMPSON, ROSS W
Entity Type:Individual
Prefix:
First Name:ROSS
Middle Name:W
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 THINK PL STE 460
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-9030
Mailing Address - Country:US
Mailing Address - Phone:984-215-6874
Mailing Address - Fax:
Practice Address - Street 1:1025 THINK PL STE 460
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-9030
Practice Address - Country:US
Practice Address - Phone:984-215-6874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS12169183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist