Timothy Haines, PHARM D
Individual provider Active NPI Pharmacist · Milan, MI
NPI 1407487176 · NPPES record last updated Jan 30, 2020
Key facts
- NPI
- 1407487176
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5302046353 (MI)
- Practice address
- 1249 Dexter St
Milan, MI 48160-1168 - Phone
- (734) 439-3000
- NPI assigned
- Jan 30, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26021811A | IN | MD | Pharmacist |
| 5302046353 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Woodward Detroit CVS, L.L.C. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 26021811A | IN | |
| Pharmacist | 183500000X | 5302046353 | MI | Yes |
Addresses
Primary practice location
1249 Dexter St
Milan, MI 48160-1168
Mailing address
1445 Belmont St
Dearborn, MI 48128-1419
Phone (574) 238-5159
Other providers in Milan, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 30, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.