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General NPI Number Information
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NPI Number | 1932021425
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Entity Type | Individual
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Provider Name | SOPHIA GRACE THOMPSON
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Gender | Female
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Dates
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Enumeration Date | 07/28/2026
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Last Update Date | 07/28/2026
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Provider Practice Location Address
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Address Line | 10122 E 10TH ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46229-2663
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Country | US
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Telephone | 317-355-5717
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Fax |
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Provider Business Mailing Address
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Address Line | 10276 LAKELAND DR
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City | FISHERS
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State | IN
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Zip | 46037-9320
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Country | US
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Telephone | 812-629-0120
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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 | 26031415A
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License Number State | IN
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