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NPI Code Detail

MEDICARE: MR. TIMOTHY Q SISK RPH

MEDICARE: MR. TIMOTHY Q SISK 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
1183500000XPharmacist6537SC

General Provider Information

NPI Number : 1578780755
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TIMOTHY Q SISK RPH
Provider Business Mailing Address
First Line : 336 RAES CREEK DR
Second Line :
City : GREENVILLE
State : SC
Zip : 29609-1989
Country : US
Telephone Number : 864-268-0130
Fax Number :
Provider Business Practice Location Address
First Line : 415 BROCKMAN MCCLIMON RD
Second Line :
City : GREER
State : SC
Zip : 29651-6608
Country : US
Telephone Number : 866-817-0411
Fax Number : 864-801-0499
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2007
Last Update Date : 09/23/2024

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Directions to “ MR. TIMOTHY Q SISK RPH” Practice Location

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