Provider Demographics
NPI:1093017519
Name:MYERS, TIMOTHY E (PHARMD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:E
Last Name:MYERS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2045 TERRA CALIFORNIA WAY
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-7026
Mailing Address - Country:US
Mailing Address - Phone:408-782-5185
Mailing Address - Fax:408-779-6730
Practice Address - Street 1:235 TENNANT STA
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-5463
Practice Address - Country:US
Practice Address - Phone:408-782-5185
Practice Address - Fax:408-779-6730
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-03
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC46549183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist