Provider Demographics
NPI:1134121700
Name:DAVIS, TIMOTHY JAMES (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:JAMES
Last Name:DAVIS
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 1:131 MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-1651
Mailing Address - Country:US
Mailing Address - Phone:724-847-0413
Mailing Address - Fax:724-847-1774
Practice Address - Street 1:525 5TH AVE
Practice Address - Street 2:BRIGHTON PHARMACY
Practice Address - City:NEW BRIGHTON
Practice Address - State:PA
Practice Address - Zip Code:15066-1737
Practice Address - Country:US
Practice Address - Phone:724-847-7979
Practice Address - Fax:724-847-1774
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP046038L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP046038LOtherSTATE LICENSE