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General NPI Number Information
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NPI Number | 1396343380
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Entity Type | Individual
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Provider Name | TIMOTHY LONDON ARCHIBALD PHARMD
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Gender | Male
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Dates
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Enumeration Date | 10/13/2020
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Last Update Date | 10/13/2020
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Provider Practice Location Address
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Address Line | 2240 N ROAN ST
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City | JOHNSON CITY
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State | TN
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Zip | 37601-2521
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Country | US
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Telephone | 423-283-4942
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Fax |
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Provider Business Mailing Address
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Address Line | 2015 WILLIAMSBURG SQ
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City | JOHNSON CITY
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State | TN
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Zip | 37604-7765
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Country | US
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Telephone | 423-747-4720
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 44133
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License Number State | TN
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