Provider Demographics
NPI:1679103832
Name:ZURN, TIM (RPH)
Entity Type:Individual
Prefix:
First Name:TIM
Middle Name:
Last Name:ZURN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5702 PEACH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-2608
Mailing Address - Country:US
Mailing Address - Phone:814-868-7805
Mailing Address - Fax:814-860-3320
Practice Address - Street 1:5702 PEACH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-2608
Practice Address - Country:US
Practice Address - Phone:814-868-7805
Practice Address - Fax:814-860-3320
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-16
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP036960L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist