Healthcare Provider Details

I. General information

NPI: 1205808441
Provider Name (Legal Business Name): E K THOMPSON & SON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 06/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 S FRANKLIN ST
TITUSVILLE PA
16354-1737
US

IV. Provider business mailing address

105 S FRANKLIN ST
TITUSVILLE PA
16354-1737
US

V. Phone/Fax

Practice location:
  • Phone: 814-827-1816
  • Fax: 814-827-1817
Mailing address:
  • Phone: 814-827-1816
  • Fax: 814-827-1817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP410638L
License Number StatePA

VIII. Authorized Official

Name: MR. RICHARD W SMITH
Title or Position: OWNER
Credential: RPH
Phone: 814-827-1816