Provider Demographics
NPI:1255606620
Name:CHAMBERS, TOBIN JOSEPH (PHARMD)
Entity type:Individual
Prefix:
First Name:TOBIN
Middle Name:JOSEPH
Last Name:CHAMBERS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 GLACIER RIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:WI
Mailing Address - Zip Code:53593-1753
Mailing Address - Country:US
Mailing Address - Phone:608-438-8930
Mailing Address - Fax:
Practice Address - Street 1:2931 S FISH HATCHERY RD
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53711-6499
Practice Address - Country:US
Practice Address - Phone:608-438-8930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-18
Last Update Date:2012-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15034-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist