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General NPI Number Information
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NPI Number | 1063710440
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Entity Type | Individual
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Provider Name | LEAH THOMPSON
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Gender | Female
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Dates
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Enumeration Date | 03/08/2011
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Last Update Date | 03/08/2011
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Provider Practice Location Address
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Address Line | 363 BLUE RIDGE ST
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City | BLAIRSVILLE
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State | GA
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Zip | 30512-3574
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Country | US
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Telephone | 706-745-6954
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Fax | 706-781-3350
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Provider Business Mailing Address
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Address Line | 4508 MURPHY HWY
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City | BLAIRSVILLE
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State | GA
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Zip | 30512-1057
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | RPH023755
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License Number State | GA
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