Provider Demographics
NPI:1942643184
Name:PAUL A THOMPSON PLLC
Entity Type:Organization
Organization Name:PAUL A THOMPSON PLLC
Other - Org Name:THOMPSON'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-734-3004
Mailing Address - Street 1:1064 N COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:HARRODSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40330-2208
Mailing Address - Country:US
Mailing Address - Phone:859-734-3004
Mailing Address - Fax:859-734-3007
Practice Address - Street 1:1064 N COLLEGE ST
Practice Address - Street 2:
Practice Address - City:HARRODSBURG
Practice Address - State:KY
Practice Address - Zip Code:40330-2208
Practice Address - Country:US
Practice Address - Phone:859-734-3004
Practice Address - Fax:859-734-3007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-08
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
KYP075643336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2140752OtherPK
KY7100255100Medicaid