MEDICARE: DR. TAMARA A THOMPSON PHARM.D.

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
1	1835P1200X	Pharmacotherapy Pharmacist	15426	CO
2	1835P1200X	Pharmacotherapy Pharmacist	2726	WY

General Provider Information

NPI Number	:	1235412651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TAMARA A THOMPSON PHARM.D.

Provider Business Mailing Address
First Line	:	20301 HIGHWAY 52
Second Line	:
City	:	FORT MORGAN
State	:	CO
Zip	:	80701-9009
Country	:	US
Telephone Number	:	970-380-0945
Fax Number	:

Provider Business Practice Location Address
First Line	:	20301 HIGHWAY 52
Second Line	:
City	:	FORT MORGAN
State	:	CO
Zip	:	80701-9009
Country	:	US
Telephone Number	:	970-380-0945
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2011
Last Update Date	:	09/21/2011

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