Healthcare Provider Details

I. General information

NPI: 1972897866
Provider Name (Legal Business Name): TIMOTHY ADAM HORWEDEL PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2011
Last Update Date: 02/23/2021
Certification Date: 02/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 SUMNEYTOWN PIKE
SPRING HOUSE PA
19477-1008
US

IV. Provider business mailing address

618 APACHE LN
PLYMOUTH MEETING PA
19462-2306
US

V. Phone/Fax

Practice location:
  • Phone: 215-646-5089
  • Fax:
Mailing address:
  • Phone: 617-413-6016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2009023442
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302038710
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP455398P
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: