Healthcare Provider Details

I. General information

NPI: 1417891714
Provider Name (Legal Business Name): ANNA THOMPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2126 LAKESHORE DR
BIRMINGHAM AL
35209
US

IV. Provider business mailing address

726 RALEIGH CT STE 200
HOMEWOOD AL
35209-8058
US

V. Phone/Fax

Practice location:
  • Phone: 205-726-2011
  • Fax:
Mailing address:
  • Phone: 618-638-4896
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License NumberS14371
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: