Broad Avenue Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP410249L Issued in PA

Legal business name

BROAD AVENUE PHARMACY LLC

Doing business as

Thompson Pharmacy

Practice address

2329 Broad Ave
Altoona, PA 16601-1979

Phone

(814) 943-1310

Fax

(814) 943-2841

NPI assigned

Jun 2, 2006

Last updated

Apr 26, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

William Thompson

Title

President

Phone

(814) 944-6139

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Thompson Pharmacy Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Peter Albert Kreckel, RPH

  • Pharmacist
  • Altoona, PA
  • NPI 1306057781
  NPD (past)
• Caitlyn Palazzi, PHARMD, RPH

  • Pharmacist
  • Altoona, PA
  • NPI 1205614278
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650931200000",
    "number": "1184661589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2329 BROAD AVE",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166011979",
            "telephone_number": "814-943-1310",
            "fax_number": "814-943-2841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2329 BROAD AVE",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166011979",
            "telephone_number": "814-943-1310",
            "fax_number": "814-943-2841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROAD AVENUE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-944-6139"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP410249L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019655640001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thompson Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Thompson Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amber Lu Brick, MSWL
• Hope Bridenbaugh
• Gerard R Brill, CRNA
• Angela Christine Brinklow, PA-C
• Alyssa Kathleen Brisbin, MD
• Broad Avenue Pharmacy LLC (Thompson Pharmacy)
• Riley Shay Brode
• Amanda Michelle Brooks, DPT, PT, ATC
• Nicole Brooks, MASSAGE THERAPIST
• Asa Brown, PA-C

• Community/Retail Pharmacy in Altoona, PA
• Providers in Altoona, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.