Provider Demographics
NPI:1558580423
Name:TIMMERMANN APOTHECARIES,INC
Entity Type:Organization
Organization Name:TIMMERMANN APOTHECARIES,INC
Other - Org Name:NEWTON-TIMMERMANN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:KEANE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:212-838-6450
Mailing Address - Street 1:799 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-8158
Mailing Address - Country:US
Mailing Address - Phone:212-838-6450
Mailing Address - Fax:212-753-3839
Practice Address - Street 1:799 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-8158
Practice Address - Country:US
Practice Address - Phone:212-838-6450
Practice Address - Fax:212-753-3839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY33379183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
3337157OtherNABP NUMBER