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NPI 1457941379

NPI 1457941379 : BRANDEN B THOMPSON PHARMD : BALTIMORE, MD

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General NPI Number Information
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    NPI Number           |    1457941379
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    Entity Type          |    Individual 
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    Provider Name        |    BRANDEN B THOMPSON PHARMD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/25/2021
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    Last Update Date     |    01/25/2021
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Provider Practice Location Address
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    Address Line         |    2560 W FRANKLIN ST 
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    City                 |    BALTIMORE
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    State                |    MD
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    Zip                  |    21223-1106
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    Country              |    US
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    Telephone            |    410-362-8803
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3424 CHESTNUT AVE 
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    City                 |    BALTIMORE
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    State                |    MD
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    Zip                  |    21211-2518
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    Country              |    US
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    Telephone            |    410-599-0006
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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       |    25346
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    License Number State |    MD
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