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NPI Code Detail

MEDICARE: DR. TIFFANY MARIE HADDAD PHARMD

MEDICARE: DR. TIFFANY MARIE HADDAD PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist03135877OH
2183500000XPharmacist5302040786MI

General Provider Information

NPI Number : 1629522792
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIFFANY MARIE HADDAD PHARMD
Provider Business Mailing Address
First Line : 3325 W CENTRAL AVE
Second Line :
City : TOLEDO
State : OH
Zip : 43606-1406
Country : US
Telephone Number : 419-531-1172
Fax Number : 419-531-5892
Provider Business Practice Location Address
First Line : 3325 W CENTRAL AVE
Second Line :
City : TOLEDO
State : OH
Zip : 43606-1406
Country : US
Telephone Number : 419-531-1172
Fax Number : 419-531-5892
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2016
Last Update Date : 08/06/2016

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