Provider Demographics
NPI:1346763471
Name:TINIUS, CASSANDRA MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:MARIE
Last Name:TINIUS
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 1:435 SWAINS DR
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-5788
Mailing Address - Country:US
Mailing Address - Phone:770-940-3649
Mailing Address - Fax:
Practice Address - Street 1:1232 HIGHWAY 74 S
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-3072
Practice Address - Country:US
Practice Address - Phone:770-631-3766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-20
Last Update Date:2017-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH029949183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist