Provider Demographics
NPI:1326527367
Name:PIERCE, TIMOTHY ANDREW (PHARMD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:ANDREW
Last Name:PIERCE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:TIMOTHY
Other - Middle Name:ANDREW
Other - Last Name:PIERCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:161 BUSH RIVER DR STE 2A
Mailing Address - Street 2:
Mailing Address - City:FARMVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23901-3183
Mailing Address - Country:US
Mailing Address - Phone:434-607-4135
Mailing Address - Fax:434-422-5698
Practice Address - Street 1:161 BUSH RIVER DR STE 2A
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901-3183
Practice Address - Country:US
Practice Address - Phone:434-607-4135
Practice Address - Fax:434-422-5698
Is Sole Proprietor?:No
Enumeration Date:2018-08-10
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202214353183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist