Timothy Alfred

Individual provider Active NPI Pharmacist · Grass Valley, CA

NPI 1730740606 · NPPES record last updated Jun 21, 2019

Key facts

NPI
1730740606
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
57058 (CA)
Practice address
2054 Nevada City Hwy
Grass Valley, CA 95945-7700
Phone
(530) 477-6857
NPI assigned
Jun 21, 2019
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
57058CAMDDentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 57058 CA Yes

Addresses

Primary practice location

2054 Nevada City Hwy
Grass Valley, CA 95945-7700

Mailing address

2054 Nevada City Hwy
Grass Valley, CA 95945-7700

Other providers in Grass Valley, CA

All providers in Grass Valley, CA · Pharmacist in California

Sources for this page

Verify at the official NPI Registry.