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NPI Code Detail

MEDICARE: TIMOTHY LASH

MEDICARE: TIMOTHY LASH
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
1183500000XPharmacist051.039138IL

General Provider Information

NPI Number : 1730781030
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY LASH
Provider Business Mailing Address
First Line : 100 S HIGH CROSS RD
Second Line :
City : URBANA
State : IL
Zip : 61802-7804
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 100 S HIGH CROSS RD
Second Line :
City : URBANA
State : IL
Zip : 61802-7804
Country : US
Telephone Number : 217-344-6190
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2020
Last Update Date : 11/11/2020

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Directions to “ TIMOTHY LASH ” Practice Location

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