Provider Demographics
NPI:1659653848
Name:MELIN, TIMOTHY ROBERT (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:ROBERT
Last Name:MELIN
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6601 MCKEE ROAD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719
Mailing Address - Country:US
Mailing Address - Phone:608-848-8285
Mailing Address - Fax:608-848-8290
Practice Address - Street 1:6601 MCKEE RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-5023
Practice Address - Country:US
Practice Address - Phone:608-848-8285
Practice Address - Fax:608-848-8290
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11085-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist