Provider Demographics
NPI:1962656769
Name:GUERIN, TIMMY ALAN (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:TIMMY
Middle Name:ALAN
Last Name:GUERIN
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 1:2055 COLISEUM BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36110-3231
Mailing Address - Country:US
Mailing Address - Phone:334-271-6457
Mailing Address - Fax:
Practice Address - Street 1:2055 COLISEUM BLVD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36110-3231
Practice Address - Country:US
Practice Address - Phone:334-271-6457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-06
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9878183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist