Provider Demographics
NPI:1063735629
Name:LUNEAU, TIMOTHY JAMES (RPH)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:JAMES
Last Name:LUNEAU
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2640 MAIN RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05462-9669
Mailing Address - Country:US
Mailing Address - Phone:802-370-9043
Mailing Address - Fax:
Practice Address - Street 1:2640 MAIN RD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:VT
Practice Address - Zip Code:05462-9669
Practice Address - Country:US
Practice Address - Phone:802-370-9043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT3502183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist