Rboin Timothy Bauer, PHARMACIST
Individual provider Active NPI Pharmacist · Union, MS
NPI 1720359003 · NPPES record last updated Jan 19, 2012
Key facts
- NPI
- 1720359003
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- E-06171 (MS)
- Practice address
- 25025 Highway 15
Union, MS 39365-8577 - Phone
- (601) 774-2772
- Fax
- (601) 774-8779
- NPI assigned
- Jan 19, 2012
- Sex
- Male
- Sole proprietor
- Yes
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-06171 | MS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Union Discount Pharmacy | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | E-06171 | MS | Yes |
Addresses
Primary practice location
25025 Highway 15
Union, MS 39365-8577
Mailing address
25025 Highway 15
Union, MS 39365-8577
Phone (601) 774-2772
Other providers in Union, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 19, 2012. 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.