Provider Demographics
NPI:1922608389
Name:TIMMS, DANIELLE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:
Last Name:TIMMS
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 1:14160 COWLEY RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA STATION
Mailing Address - State:OH
Mailing Address - Zip Code:44028-9121
Mailing Address - Country:US
Mailing Address - Phone:216-310-1880
Mailing Address - Fax:
Practice Address - Street 1:10000 BROOKPARK RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-1102
Practice Address - Country:US
Practice Address - Phone:216-741-7386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03325739183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist