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General NPI Number Information
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NPI Number | 1023120508
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Entity Type | Organization
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Legal Business Name | THOMPSON DRUG SOUTH, INC.
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 01/23/2024
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Provider Practice Location Address
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Address Line | 975 S LAUREL RD STE A
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City | LONDON
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State | KY
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Zip | 40744-7862
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Country | US
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Telephone | 606-864-6324
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Fax | 606-877-9634
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Provider Business Mailing Address
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Address Line | 975 S LAUREL RD STE A
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City | LONDON
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State | KY
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Zip | 40744-7862
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Country | US
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Telephone | 606-864-6324
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Fax | 606-877-3197
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. RANDY PRICE WINDHAM
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Credential | R.PH.
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Telephone | 606-864-6324
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 008633
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 4505240001
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | P06392
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License Number State | KY
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