Provider Demographics
NPI:1225202443
Name:ROCHE, TIMOTHY DEAN JR (PHARMD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:DEAN
Last Name:ROCHE
Suffix:JR
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 1:1757 CASON TRL
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37128-5033
Mailing Address - Country:US
Mailing Address - Phone:615-584-5202
Mailing Address - Fax:615-904-9881
Practice Address - Street 1:2485 MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-5110
Practice Address - Country:US
Practice Address - Phone:615-904-9907
Practice Address - Fax:615-904-9881
Is Sole Proprietor?:No
Enumeration Date:2008-04-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29211183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist