=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326035791
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMES ADDISON THOMPSON JR. RPH
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/30/2005
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2000 FAIRVIEW RD
-----------------------------------------------------
City | RALEIGH
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27608-2316
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-832-4641
-----------------------------------------------------
Fax | 919-832-0291
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8400 OLD WELL LN RALEIGH
-----------------------------------------------------
City | RALEIGH
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27615-2942
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-832-4641
-----------------------------------------------------
Fax | 919-832-0291
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1835P1200X
-----------------------------------------------------
Taxonomy Name | Pharmacotherapy Pharmacist
-----------------------------------------------------
License Number | 5965
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------