Provider Demographics
NPI:1629952304
Name:THOMPSON, SAMUEL II
Entity type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:
Last Name:THOMPSON
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W MAIN ST STE 111
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-2023
Mailing Address - Country:US
Mailing Address - Phone:215-518-3625
Mailing Address - Fax:
Practice Address - Street 1:100 W MAIN ST STE 111
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-2023
Practice Address - Country:US
Practice Address - Phone:215-518-3625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA83953601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health