Provider Demographics
NPI:1093934085
Name:PATTON, TIMOTHY JOHN SR (RPH)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:JOHN
Last Name:PATTON
Suffix:SR
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 1:860 W GRANDVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-1507
Mailing Address - Country:US
Mailing Address - Phone:814-866-6748
Mailing Address - Fax:
Practice Address - Street 1:16395 ROUTE 8
Practice Address - Street 2:UNION CITY PHARMACY
Practice Address - City:UNION CITY
Practice Address - State:PA
Practice Address - Zip Code:16438-1501
Practice Address - Country:US
Practice Address - Phone:814-438-7570
Practice Address - Fax:814-438-2229
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP026531L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist