Provider Demographics
NPI:1962523985
Name:THOMPSON, JULIE LYNN (RPH)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:LYNN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 SUMMIT DR
Mailing Address - Street 2:
Mailing Address - City:SHIPPENVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16254-8616
Mailing Address - Country:US
Mailing Address - Phone:814-223-9850
Mailing Address - Fax:
Practice Address - Street 1:849 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CLARION
Practice Address - State:PA
Practice Address - Zip Code:16214-1161
Practice Address - Country:US
Practice Address - Phone:814-393-0000
Practice Address - Fax:814-226-6641
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP038167L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist