Provider Demographics
NPI:1457531006
Name:TIMS PHARMACY INC
Entity Type:Organization
Organization Name:TIMS PHARMACY INC
Other - Org Name:TIMS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:BS PHARMACY
Authorized Official - Phone:706-776-3784
Mailing Address - Street 1:PO BOX 457
Mailing Address - Street 2:
Mailing Address - City:CORNELIA
Mailing Address - State:GA
Mailing Address - Zip Code:30531-1006
Mailing Address - Country:US
Mailing Address - Phone:706-776-3784
Mailing Address - Fax:706-776-3788
Practice Address - Street 1:130 MAGNOLIA LN
Practice Address - Street 2:
Practice Address - City:CORNELIA
Practice Address - State:GA
Practice Address - Zip Code:30531-2297
Practice Address - Country:US
Practice Address - Phone:706-776-3784
Practice Address - Fax:706-776-3788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE0094093336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2016759OtherPK