Provider Demographics
NPI:1275018889
Name:FRANCO, TIFFANY AMBER (RPH)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:AMBER
Last Name:FRANCO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 MACCORKLE AVE SW
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-1109
Mailing Address - Country:US
Mailing Address - Phone:304-766-0900
Mailing Address - Fax:304-766-0901
Practice Address - Street 1:5151 MACCORKLE AVE SW
Practice Address - Street 2:
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-1109
Practice Address - Country:US
Practice Address - Phone:304-766-0900
Practice Address - Fax:304-766-0901
Is Sole Proprietor?:No
Enumeration Date:2018-09-28
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0007870183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist