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General NPI Number Information
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NPI Number | 1477156149
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Entity Type | Individual
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Provider Name | TIFFANY ANDREWS PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 11/17/2020
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Last Update Date | 11/17/2020
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Provider Practice Location Address
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Address Line | 705 W MAIN ST
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City | BENTON
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State | IL
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Zip | 62812-1329
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Country | US
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Telephone | 618-439-6356
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Fax |
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Provider Business Mailing Address
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Address Line | 410 E 3RD ST S
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City | ROYALTON
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State | IL
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Zip | 62983-1339
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Country | US
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Telephone | 618-751-9723
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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 | 051297105
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License Number State | IL
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