Provider Demographics
NPI:1982924783
Name:THOMPSON, REBEKAH SHAW (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:REBEKAH
Middle Name:SHAW
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3027 WADE HAMPTON BLVD
Mailing Address - Street 2:
Mailing Address - City:TAYLORS
Mailing Address - State:SC
Mailing Address - Zip Code:29687-2789
Mailing Address - Country:US
Mailing Address - Phone:864-292-2014
Mailing Address - Fax:
Practice Address - Street 1:3027 WADE HAMPTON BLVD
Practice Address - Street 2:
Practice Address - City:TAYLORS
Practice Address - State:SC
Practice Address - Zip Code:29687-2789
Practice Address - Country:US
Practice Address - Phone:864-292-2014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-03
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12613183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist