Provider Demographics
NPI:1023136819
Name:THOMPSON, DONALD L (RPH)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:L
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 OHMER ST
Mailing Address - Street 2:P.O. BOX 85
Mailing Address - City:BOTTINEAU
Mailing Address - State:ND
Mailing Address - Zip Code:58318-1621
Mailing Address - Country:US
Mailing Address - Phone:701-228-5194
Mailing Address - Fax:
Practice Address - Street 1:505 MAIN ST
Practice Address - Street 2:
Practice Address - City:BOTTINEAU
Practice Address - State:ND
Practice Address - Zip Code:58318-1202
Practice Address - Country:US
Practice Address - Phone:701-228-2291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND3906183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist