Healthcare Provider Details

I. General information

NPI: 1114081973
Provider Name (Legal Business Name): THOMPSON DRUG COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 EAST ST PAUL STREET
SPRING VALLEY IL
61362-2099
US

IV. Provider business mailing address

130 EAST ST PAUL STREET
SPRING VALLEY IL
61362-2099
US

V. Phone/Fax

Practice location:
  • Phone: 815-663-4711
  • Fax: 815-663-5005
Mailing address:
  • Phone: 815-663-4711
  • Fax: 815-663-5005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StateIL

VIII. Authorized Official

Name: MR. TERRY G THOMPSON
Title or Position: PRESIDENT
Credential: R PH
Phone: 815-663-4711