Healthcare Provider Details

I. General information

NPI: 1649360710
Provider Name (Legal Business Name): TIMOTHY W FORESTER R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4080 WASHINGTON RD SUITE 106
MCMURRAY PA
15317-2561
US

IV. Provider business mailing address

4080 WASHINGTON RD SUITE 106
MCMURRAY PA
15317-2561
US

V. Phone/Fax

Practice location:
  • Phone: 724-941-2522
  • Fax: 724-942-8386
Mailing address:
  • Phone: 724-941-2522
  • Fax: 724-942-8386

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP044091L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: