Provider Demographics
NPI:1649360710
Name:FORESTER, TIMOTHY W (RPH)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:W
Last Name:FORESTER
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 1:4080 WASHINGTON RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:MCMURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-2561
Mailing Address - Country:US
Mailing Address - Phone:724-941-2522
Mailing Address - Fax:724-942-8386
Practice Address - Street 1:4080 WASHINGTON RD
Practice Address - Street 2:SUITE 106
Practice Address - City:MCMURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-2561
Practice Address - Country:US
Practice Address - Phone:724-941-2522
Practice Address - Fax:724-942-8386
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP044091L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist