Provider Demographics
NPI:1548910169
Name:DEEB, TIMOTHY SAAD (PHARMD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:SAAD
Last Name:DEEB
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 1:155 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:WELCH
Mailing Address - State:WV
Mailing Address - Zip Code:24801-2627
Mailing Address - Country:US
Mailing Address - Phone:304-887-5899
Mailing Address - Fax:
Practice Address - Street 1:730 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:WELCH
Practice Address - State:WV
Practice Address - Zip Code:24801-2339
Practice Address - Country:US
Practice Address - Phone:304-436-6360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-26
Last Update Date:2022-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0011431183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist