Provider Demographics
NPI:1871879031
Name:THOMPSON, JENNIFER CUNARD (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:CUNARD
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4725 WEST OX ROAD
Mailing Address - Street 2:PHARMACY
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030
Mailing Address - Country:US
Mailing Address - Phone:703-802-1229
Mailing Address - Fax:703-332-3221
Practice Address - Street 1:4725 WEST OX ROAD
Practice Address - Street 2:PHARMACY
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030
Practice Address - Country:US
Practice Address - Phone:703-802-1229
Practice Address - Fax:703-332-3221
Is Sole Proprietor?:No
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202204718183500000X
MD20084183500000X
FLPS47960183500000X
DEA10004161183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist