Provider Demographics
NPI:1740691856
Name:HUNDLEY, TIFFANI
Entity type:Individual
Prefix:MRS
First Name:TIFFANI
Middle Name:
Last Name:HUNDLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3298 ELIDA RD
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-1220
Mailing Address - Country:US
Mailing Address - Phone:419-331-6433
Mailing Address - Fax:419-331-6463
Practice Address - Street 1:3298 ELIDA RD
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45805-1220
Practice Address - Country:US
Practice Address - Phone:419-331-6433
Practice Address - Fax:419-331-6463
Is Sole Proprietor?:No
Enumeration Date:2014-05-12
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03324138183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist