Provider Demographics
NPI:1477156149
Name:ANDREWS, TIFFANY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:
Other - Last Name:GRZEGORZEWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:410 E 3RD ST S
Mailing Address - Street 2:
Mailing Address - City:ROYALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62983-1339
Mailing Address - Country:US
Mailing Address - Phone:618-751-9723
Mailing Address - Fax:
Practice Address - Street 1:705 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:IL
Practice Address - Zip Code:62812-1329
Practice Address - Country:US
Practice Address - Phone:618-439-6356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051297105183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist