Provider Demographics
NPI:1891776803
Name:LIGHTNER, TIFFANY (RPH)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:LIGHTNER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3913 HARTZDALE DR
Mailing Address - Street 2:SUITE 1306
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-7845
Mailing Address - Country:US
Mailing Address - Phone:717-695-9082
Mailing Address - Fax:717-695-9538
Practice Address - Street 1:3913 HARTZDALE DR
Practice Address - Street 2:SUITE 1306
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-7845
Practice Address - Country:US
Practice Address - Phone:717-695-9082
Practice Address - Fax:717-695-9538
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP039875L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist