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General NPI Number Information
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NPI Number | 1336391374
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Entity Type | Individual
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Provider Name | DR. ERIC THOMPSON
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Gender | Male
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Dates
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Enumeration Date | 10/22/2008
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Last Update Date | 10/22/2008
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Provider Practice Location Address
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Address Line | 4018 N MCCORD RD
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City | SYLVANIA
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State | OH
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Zip | 43560-3264
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Country | US
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Telephone | 419-885-2989
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Fax |
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Provider Business Mailing Address
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Address Line | 29239 TRACY CREEK DR APT. 2B
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City | PERRYSBURG
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State | OH
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Zip | 43551-7359
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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 | 03227900
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License Number State | OH
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