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NPI Code Detail

MEDICARE: TIMOTHY SMITH PHARMD

MEDICARE: TIMOTHY SMITH PHARMD
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
1183500000XPharmacist21479-40WI

General Provider Information

NPI Number : 1629936000
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY SMITH PHARMD
Provider Business Mailing Address
First Line : 1323 PRAIRIE ROSE DR
Second Line :
City : SUN PRAIRIE
State : WI
Zip : 53590-4314
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5185 S 9TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53221-3627
Country : US
Telephone Number : 608-893-5586
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2026
Last Update Date : 01/13/2026

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Directions to “ TIMOTHY SMITH PHARMD” Practice Location

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