Provider Demographics
NPI:1700934999
Name:PARHAM, TIMOTHY RICHARD (RPH)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:RICHARD
Last Name:PARHAM
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 1:3900 38TH ST S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33711-4322
Mailing Address - Country:US
Mailing Address - Phone:727-865-1294
Mailing Address - Fax:
Practice Address - Street 1:11100 4TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716-2900
Practice Address - Country:US
Practice Address - Phone:727-579-1433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0022208183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist