Provider Demographics
NPI:1689021750
Name:THOMPSON-EALY, DEBORAH (PHARMD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:THOMPSON-EALY
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 1:20180 US HIGHWAY 18
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-2919
Mailing Address - Country:US
Mailing Address - Phone:760-946-3335
Mailing Address - Fax:760-946-2634
Practice Address - Street 1:20180 US HIGHWAY 18
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-2919
Practice Address - Country:US
Practice Address - Phone:760-946-3335
Practice Address - Fax:760-946-2634
Is Sole Proprietor?:No
Enumeration Date:2016-05-19
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48954183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist