=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376875476
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALECIA MARIE THOMPSON RPH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/01/2010
-----------------------------------------------------
Last Update Date | 02/01/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 43 NEW SCOTLAND AVE # MC85
-----------------------------------------------------
City | ALBANY
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12208-3412
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 518-262-3271
-----------------------------------------------------
Fax | 518-262-8010
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 43 NEW SCOTLAND AVE # 85
-----------------------------------------------------
City | ALBANY
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12208-3412
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 518-262-3271
-----------------------------------------------------
Fax | 518-262-8010
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 043935
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------