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General NPI Number Information
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NPI Number | 1306145180
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Entity Type | Individual
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Provider Name | CHARLES ELLSWORTH THOMPSON III R.PH
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Gender | Male
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Dates
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Enumeration Date | 03/20/2011
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Last Update Date | 03/20/2011
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Provider Practice Location Address
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Address Line | 4396 HIGHWAY 24
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City | ANDERSON
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State | SC
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Zip | 29626-5212
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Country | US
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Telephone | 864-226-2398
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Fax | 864-375-0179
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Provider Business Mailing Address
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Address Line | 4396 HIGHWAY 24
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City | ANDERSON
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State | SC
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Zip | 29626-5212
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Country | US
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Telephone | 864-226-2398
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Fax | 864-375-0179
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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 | 010629
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License Number State | SC
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