Provider Demographics
NPI:1669453312
Name:THOMPSON & THOMPSON LONG TERM CARE INC
Entity Type:Organization
Organization Name:THOMPSON & THOMPSON LONG TERM CARE INC
Other - Org Name:BROOKLYN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
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 1:101 E FRONT ST
Mailing Address - Street 2:PO BOX 454
Mailing Address - City:BROOKLYN
Mailing Address - State:IA
Mailing Address - Zip Code:52211-7721
Mailing Address - Country:US
Mailing Address - Phone:641-522-7813
Mailing Address - Fax:641-522-5469
Practice Address - Street 1:101 E FRONT ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:IA
Practice Address - Zip Code:52211-7721
Practice Address - Country:US
Practice Address - Phone:641-522-7813
Practice Address - Fax:641-522-5469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-09
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
IA3273336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1669453312Medicaid
2125769OtherPK