Healthcare Provider Details

I. General information

NPI: 1922517325
Provider Name (Legal Business Name): TIMOTHY NICHOL PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2017
Last Update Date: 12/14/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 MALL BLVD
MONROEVILLE PA
15146-2213
US

IV. Provider business mailing address

4221 HIGH STAKES CIR APT 319
PARKTON NC
28371-9112
US

V. Phone/Fax

Practice location:
  • Phone: 800-283-7828
  • Fax:
Mailing address:
  • Phone: 412-328-4842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number27424
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP452026
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: