Provider Demographics
NPI:1558407502
Name:MORRISSEY, ROBERT TIMOTHY (PHARM D)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:TIMOTHY
Last Name:MORRISSEY
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 1:490 SANTEE BLVD
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:NE
Mailing Address - Zip Code:68450-2518
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:490 SANTEE BLVD
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:NE
Practice Address - Zip Code:68450-2518
Practice Address - Country:US
Practice Address - Phone:402-658-9615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT12075183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist