MEDICARE: THOMPSONS NEIGHBORHOOD PHARMACY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	022549700	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2155893	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801265889
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMPSONS NEIGHBORHOOD PHARMACY LLC

Provider Business Mailing Address
First Line	:	4889 AUGUSTA WOODS CT
Second Line	:
City	:	WESTERVILLE
State	:	OH
Zip	:	43082
Country	:	US
Telephone Number	:	614-388-8088
Fax Number	:	614-388-8089

Provider Business Practice Location Address
First Line	:	2343 CLEVELAND AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43211-1611
Country	:	US
Telephone Number	:	614-388-8088
Fax Number	:	614-388-8089

Authorized Official
Title or Position	:	MANAGER/AO
Name	:	NATHANAEL THOMPSON
Credential	:
Telephone Number	:	614-937-4957

Provider Enumeration Date	:	09/19/2015
Last Update Date	:	07/19/2018

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