Provider Demographics
NPI:1659867646
Name:THOMPSON, ALANA MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALANA
Middle Name:MARIE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 CHRISTOPHER ST APT 28
Mailing Address - Street 2:
Mailing Address - City:RAINBOW CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35906-3501
Mailing Address - Country:US
Mailing Address - Phone:256-345-4269
Mailing Address - Fax:
Practice Address - Street 1:1950 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CENTRE
Practice Address - State:AL
Practice Address - Zip Code:35960-2811
Practice Address - Country:US
Practice Address - Phone:256-927-9911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-03
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL19798183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL19798OtherALABAMA BOARD OF PHARMACY-PHARMACIST LICENSE