Provider Demographics
NPI:1043445406
Name:SMITH, TIMOTHY BRIAN (RPH)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:BRIAN
Last Name:SMITH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1328 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:EMMAUS
Mailing Address - State:PA
Mailing Address - Zip Code:18049-1921
Mailing Address - Country:US
Mailing Address - Phone:610-967-6440
Mailing Address - Fax:610-966-7695
Practice Address - Street 1:1328 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:EMMAUS
Practice Address - State:PA
Practice Address - Zip Code:18049-1921
Practice Address - Country:US
Practice Address - Phone:610-967-6440
Practice Address - Fax:610-966-7695
Is Sole Proprietor?:No
Enumeration Date:2009-05-28
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP033146L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist