Provider Demographics
NPI:1518390129
Name:HUGHES, TIMOTHY (PHARM D)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:HUGHES
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85201-6605
Mailing Address - Country:US
Mailing Address - Phone:480-628-2261
Mailing Address - Fax:
Practice Address - Street 1:1142 W GUADALUPE RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-7602
Practice Address - Country:US
Practice Address - Phone:480-345-7367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-19
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS020044183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist