Healthcare Provider Details

I. General information

NPI: 1598019762
Provider Name (Legal Business Name): TIMI PHARMACY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2012
Last Update Date: 03/05/2024
Certification Date: 03/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

723 N BROAD ST
MIDDLETOWN DE
19709-1166
US

IV. Provider business mailing address

723 N BROAD ST
MIDDLETOWN DE
19709-1166
US

V. Phone/Fax

Practice location:
  • Phone: 302-378-8228
  • Fax: 302-378-7338
Mailing address:
  • Phone: 347-574-4754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: IDAYAT ADEWUNMI
Title or Position: OWNER
Credential:
Phone: 347-574-4754