Provider Demographics
NPI:1124754304
Name:HABECK, TIMOTHY ALLEN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:ALLEN
Last Name:HABECK
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 N YANKEE AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57110-8575
Mailing Address - Country:US
Mailing Address - Phone:712-229-0143
Mailing Address - Fax:
Practice Address - Street 1:800 N YANKEE AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57110-8575
Practice Address - Country:US
Practice Address - Phone:712-229-0143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-28
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD5983183500000X
IA22971183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist