Healthcare Provider Details

I. General information

NPI: 1053860486
Provider Name (Legal Business Name): THOMPSON DRUG ANNVILLE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2016
Last Update Date: 01/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78 HIGHWAY 3444 STE 2
ANNVILLE KY
40402-8245
US

IV. Provider business mailing address

810 E 4TH ST
LONDON KY
40741-1428
US

V. Phone/Fax

Practice location:
  • Phone: 606-364-3113
  • Fax: 606-364-2977
Mailing address:
  • Phone: 606-878-7713
  • Fax: 606-878-9458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP07811
License Number StateKY

VIII. Authorized Official

Name: BRITT THOMPSON
Title or Position: PRESIDENT
Credential:
Phone: 606-878-7713