Provider Demographics
NPI:1629376728
Name:THOMPSON, ERIN SUTPHEN (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:SUTPHEN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:MISS
Other - First Name:ERIN
Other - Middle Name:ELIZABETH
Other - Last Name:SUTPHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:7321 BALMER ST
Mailing Address - Street 2:BUILDING 570
Mailing Address - City:HILL AFB
Mailing Address - State:UT
Mailing Address - Zip Code:84056-5012
Mailing Address - Country:US
Mailing Address - Phone:801-777-0419
Mailing Address - Fax:801-586-9890
Practice Address - Street 1:7321 BALMER ST
Practice Address - Street 2:BUILDING 570
Practice Address - City:HILL AFB
Practice Address - State:UT
Practice Address - Zip Code:84056-5012
Practice Address - Country:US
Practice Address - Phone:801-777-0419
Practice Address - Fax:801-586-9890
Is Sole Proprietor?:No
Enumeration Date:2011-03-14
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS43829183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist