Provider Demographics
NPI:1306376041
Name:TIMI PHARMACEUTICALS INC
Entity Type:Organization
Organization Name:TIMI PHARMACEUTICALS INC
Other - Org Name:PELHAM PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IDAYAT
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEWUNMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-574-4754
Mailing Address - Street 1:6555 GREENE ST STE 3
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-4040
Mailing Address - Country:US
Mailing Address - Phone:215-848-0500
Mailing Address - Fax:
Practice Address - Street 1:6555 GREENE ST STE 3
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19119-4040
Practice Address - Country:US
Practice Address - Phone:215-848-0500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP4821923336L0003X
3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy