Healthcare Provider Details

I. General information

NPI: 1962523985
Provider Name (Legal Business Name): JULIE LYNN THOMPSON RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

849 E MAIN ST
CLARION PA
16214-1161
US

IV. Provider business mailing address

104 SUMMIT DR
SHIPPENVILLE PA
16254-8616
US

V. Phone/Fax

Practice location:
  • Phone: 814-393-0000
  • Fax: 814-226-6641
Mailing address:
  • Phone: 814-223-9850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP038167L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: