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NPI Code Detail

MEDICARE: COREY THOMPSON RPH

MEDICARE: COREY THOMPSON RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist03323719OH

General Provider Information

NPI Number : 1053692103
Entity Type Code : Individual
Provider Name (Legal Business Name) : COREY THOMPSON RPH
Provider Business Mailing Address
First Line : 1000 PARK AVE W
Second Line :
City : MANSFIELD
State : OH
Zip : 44906-2810
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1000 PARK AVE W
Second Line :
City : MANSFIELD
State : OH
Zip : 44906-2810
Country : US
Telephone Number : 419-529-3790
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2011
Last Update Date : 09/02/2011

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Directions to “ COREY THOMPSON RPH” Practice Location

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