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NPI Code Detail

MEDICARE: MR. TIMOTHY M. NELSON RPH

MEDICARE: MR. TIMOTHY M. NELSON RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist0202009126VA

General Provider Information

NPI Number : 1043521578
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TIMOTHY M. NELSON RPH
Provider Business Mailing Address
First Line : 1057 NORWICH AVE
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23455-4653
Country : US
Telephone Number : 757-461-2954
Fax Number :
Provider Business Practice Location Address
First Line : 7601 GRANBY ST
Second Line :
City : NORFOLK
State : VA
Zip : 23505-2508
Country : US
Telephone Number : 757-489-1157
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2010
Last Update Date : 06/30/2010

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Directions to “ MR. TIMOTHY M. NELSON RPH” Practice Location

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