Provider Demographics
NPI:1346530300
Name:TINER, HALEY MELISSA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HALEY
Middle Name:MELISSA
Last Name:TINER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DONALSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:39845-1506
Mailing Address - Country:US
Mailing Address - Phone:229-524-1126
Mailing Address - Fax:229-524-8998
Practice Address - Street 1:100 W 3RD ST
Practice Address - Street 2:
Practice Address - City:DONALSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:39845-1506
Practice Address - Country:US
Practice Address - Phone:229-524-1126
Practice Address - Fax:229-524-8998
Is Sole Proprietor?:No
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH023610183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist