Healthcare Provider Details

I. General information

NPI: 1417137746
Provider Name (Legal Business Name): TIMOTHY JOHN MCLAUGHLIN RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2007
Last Update Date: 05/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 W WASHINGTON ST ATT PHARMACY DEPT
BATH NY
14810-1017
US

IV. Provider business mailing address

321 W WASHINGTON ST ATT PHARMACY DEPT
BATH NY
14810-1017
US

V. Phone/Fax

Practice location:
  • Phone: 607-776-1282
  • Fax: 607-776-1592
Mailing address:
  • Phone: 607-776-6039
  • Fax: 607-776-7518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number037494
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: