Individual
TIMOTHY JOHN BLACKFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
3600 30TH ST, VA HOSPITAL, DES MOINES, IA 50310
(800) 294-8387
Mailing address
2534 MADISON AVE, DES MOINES, IA 50310-5918
(515) 279-6307
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16211
IA
Other
Enumeration date
09/22/2006
Last updated
07/08/2007
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