Provider Demographics
NPI:1285610642
Name:LANGFORD, TIMOTHY GEORGE (PHARMD, BCPS, CDE)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:GEORGE
Last Name:LANGFORD
Suffix:
Gender:M
Credentials:PHARMD, BCPS, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 S CHILOQUIN BLVD
Mailing Address - Street 2:PO BOX 490
Mailing Address - City:CHILOQUIN
Mailing Address - State:OR
Mailing Address - Zip Code:97624-6747
Mailing Address - Country:US
Mailing Address - Phone:541-882-1487
Mailing Address - Fax:541-783-3554
Practice Address - Street 1:330 S CHILOQUIN BLVD
Practice Address - Street 2:
Practice Address - City:CHILOQUIN
Practice Address - State:OR
Practice Address - Zip Code:97624-6747
Practice Address - Country:US
Practice Address - Phone:541-882-1487
Practice Address - Fax:541-783-3554
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0010620183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist