Provider Demographics
NPI:1265573679
Name:ORR, TIMOTHY CHARLES (RPH)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:CHARLES
Last Name:ORR
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 1:11780 STEPPING STONE DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-3917
Mailing Address - Country:US
Mailing Address - Phone:317-596-8034
Mailing Address - Fax:
Practice Address - Street 1:4005 W KILGORE AVE
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-4815
Practice Address - Country:US
Practice Address - Phone:765-286-6337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26002105183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist