Provider Demographics
NPI:1770980781
Name:TOONE, TIFFANIE S (PHARMD)
Entity type:Individual
Prefix:
First Name:TIFFANIE
Middle Name:S
Last Name:TOONE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 MONROE AVE APT E
Mailing Address - Street 2:
Mailing Address - City:GREEN RIVER
Mailing Address - State:WY
Mailing Address - Zip Code:82935
Mailing Address - Country:US
Mailing Address - Phone:801-821-1587
Mailing Address - Fax:
Practice Address - Street 1:135 MONROE AVE APT E
Practice Address - Street 2:
Practice Address - City:GREEN RIVER
Practice Address - State:WY
Practice Address - Zip Code:82935-5135
Practice Address - Country:US
Practice Address - Phone:801-821-1587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-20
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY3788183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist