Provider Demographics
NPI:1518253681
Name:TIMMS, KARI (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KARI
Middle Name:
Last Name:TIMMS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 PAUL BUNYAN DR NW
Mailing Address - Street 2:T-0657
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-5645
Mailing Address - Country:US
Mailing Address - Phone:218-759-0133
Mailing Address - Fax:218-759-0133
Practice Address - Street 1:2100 PAUL BUNYAN DR NW
Practice Address - Street 2:T-0657
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-5645
Practice Address - Country:US
Practice Address - Phone:218-759-0133
Practice Address - Fax:218-759-0133
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN117092183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist