Provider Demographics
NPI:1982042552
Name:TEMELKOFF, TIMOTHY BRIAN (RPH)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:BRIAN
Last Name:TEMELKOFF
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 1:4799 GLANSTONBURY CT
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-8655
Mailing Address - Country:US
Mailing Address - Phone:614-395-9003
Mailing Address - Fax:
Practice Address - Street 1:4799 GLANSTONBURY CT
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-8655
Practice Address - Country:US
Practice Address - Phone:614-395-9003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03117337183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist