Provider Demographics
NPI:1447459904
Name:HEIMANN, TIMOTHY M
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:M
Last Name:HEIMANN
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:TIM
Other - Middle Name:M
Other - Last Name:HEIMANN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:10060 APACHE DR
Mailing Address - Street 2:APT 203
Mailing Address - City:PARMA HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-9084
Mailing Address - Country:US
Mailing Address - Phone:440-882-3293
Mailing Address - Fax:
Practice Address - Street 1:10701 EAST BLVD
Practice Address - Street 2:PHARMACY SERVIE 119 W
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1702
Practice Address - Country:US
Practice Address - Phone:216-791-3800
Practice Address - Fax:216-231-3291
Is Sole Proprietor?:No
Enumeration Date:2007-07-15
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-28477183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist