MEDICARE: AYLA THOMPSON PHARMACIST

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	183500000X	Pharmacist	064755	NY

General Provider Information

NPI Number	:	1730663998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AYLA THOMPSON PHARMACIST

Provider Business Mailing Address
First Line	:	301 CORNELIA ST
Second Line	:
City	:	PLATTSBURGH
State	:	NY
Zip	:	12901-2308
Country	:	US
Telephone Number	:	518-314-6487
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 CORNELIA ST
Second Line	:
City	:	PLATTSBURGH
State	:	NY
Zip	:	12901-2308
Country	:	US
Telephone Number	:	518-314-6487
Fax Number	:

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

Provider Enumeration Date	:	09/23/2018
Last Update Date	:	12/29/2022

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