Provider Demographics
NPI:1730880527
Name:AMIS, TIMOTHY (PHARMD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:AMIS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4307 WILGROVE MINT HILL RD
Mailing Address - Street 2:
Mailing Address - City:MINT HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28227-3400
Mailing Address - Country:US
Mailing Address - Phone:704-545-3420
Mailing Address - Fax:
Practice Address - Street 1:4307 WILGROVE MINT HILL RD
Practice Address - Street 2:
Practice Address - City:MINT HILL
Practice Address - State:NC
Practice Address - Zip Code:28227-3400
Practice Address - Country:US
Practice Address - Phone:342-070-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC31865183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist