Provider Demographics
NPI:1053346684
Name:THOMPSON DRUG DOWNTOWN, INC.
Entity type:Organization
Organization Name:THOMPSON DRUG DOWNTOWN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WINDHAM
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:606-877-1008
Mailing Address - Street 1:803 MEYERS BAKER ROAD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40741
Mailing Address - Country:US
Mailing Address - Phone:606-877-1008
Mailing Address - Fax:606-864-3127
Practice Address - Street 1:803 MEYERS BAKER ROAD
Practice Address - Street 2:SUITE 110
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741
Practice Address - Country:US
Practice Address - Phone:606-862-6261
Practice Address - Fax:606-864-3127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP06244332B00000X, 333600000X, 3336C0004X, 3336C0004X
KYPO62443336C0003X, 3336C0003X
3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Yes333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY90200635Medicaid
1824348OtherOTHER ID NUMBER
KY54031604Medicaid
6682640001Medicare NSC