Provider Demographics
NPI:1184490716
Name:THORNHILL, JUSTIN ANDREW (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:ANDREW
Last Name:THORNHILL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1733 2ND ST S
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39301-4514
Mailing Address - Country:US
Mailing Address - Phone:601-485-2218
Mailing Address - Fax:
Practice Address - Street 1:2400 HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39307-9377
Practice Address - Country:US
Practice Address - Phone:601-482-3170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-101273183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist