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General NPI Number Information
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NPI Number | 1730847864
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Entity Type | Individual
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Provider Name | PHILIP THOMPSON PHARMD
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Gender | Male
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Dates
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Enumeration Date | 12/06/2021
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Last Update Date | 07/22/2023
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Provider Practice Location Address
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Address Line | 222 E BROADWAY
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City | COLUMBIA
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State | MO
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Zip | 65203-4258
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Country | US
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Telephone | 573-874-3562
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Fax |
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Provider Business Mailing Address
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Address Line | 5135 CLARK LN APT 100
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City | COLUMBIA
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State | MO
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Zip | 65202-9919
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Country | US
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Telephone | 407-488-6061
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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 | PS58823
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2023014774
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License Number State | MO
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