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NPI Code Detail

MEDICARE: CARLEE THOMPSON

MEDICARE:   CARLEE  THOMPSON
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
1183500000XPharmacist26025193AIN

General Provider Information

NPI Number : 1275179277
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLEE THOMPSON
Provider Business Mailing Address
First Line : 4422 REGATTA DR
Second Line :
City : LAFAYETTE
State : IN
Zip : 47909-8476
Country : US
Telephone Number : 219-863-2706
Fax Number :
Provider Business Practice Location Address
First Line : 2200 GREENBUSH ST
Second Line :
City : LAFAYETTE
State : IN
Zip : 47904-2342
Country : US
Telephone Number : 765-448-9159
Fax Number : 765-448-9184
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/25/2019
Last Update Date : 11/25/2019

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Directions to “ CARLEE THOMPSON ” Practice Location

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