Provider Demographics
NPI:1730783101
Name:OVERPECK, TIMOTHY RYAN (PHARMD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:RYAN
Last Name:OVERPECK
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 1:820 W OHIO ST
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47872-1532
Mailing Address - Country:US
Mailing Address - Phone:765-569-2313
Mailing Address - Fax:765-569-5317
Practice Address - Street 1:820 W OHIO ST
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:IN
Practice Address - Zip Code:47872-1532
Practice Address - Country:US
Practice Address - Phone:765-569-2313
Practice Address - Fax:765-569-5317
Is Sole Proprietor?:No
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26023167A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist