Provider Demographics
NPI:1790388452
Name:THORNHILL, LYDIA
Entity Type:Individual
Prefix:DR
First Name:LYDIA
Middle Name:
Last Name:THORNHILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 RAY THORINGTON RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-8935
Mailing Address - Country:US
Mailing Address - Phone:334-215-4381
Mailing Address - Fax:
Practice Address - Street 1:55 RAY THORINGTON RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-8935
Practice Address - Country:US
Practice Address - Phone:334-215-4381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17796183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist