Provider Demographics
NPI:1598168049
Name:PHIAPALATH, TIFFANY BREWER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:BREWER
Last Name:PHIAPALATH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11635 HIGHWAY 70
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38002-9778
Mailing Address - Country:US
Mailing Address - Phone:901-290-9270
Mailing Address - Fax:
Practice Address - Street 1:500 S 99TH AVE
Practice Address - Street 2:
Practice Address - City:TOLLESON
Practice Address - State:AZ
Practice Address - Zip Code:85353-9700
Practice Address - Country:US
Practice Address - Phone:623-907-4938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-29
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN383881835P0018X, 183500000X
AZS0222821835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist