Provider Demographics
NPI:1568442358
Name:EKOLA, TIMOTHY ALLEN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:ALLEN
Last Name:EKOLA
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:CMR 402
Mailing Address - Street 2:BOX 2251
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09180-0402
Mailing Address - Country:US
Mailing Address - Phone:011491609-131-3467
Mailing Address - Fax:
Practice Address - Street 1:CMR 402
Practice Address - Street 2:ATTN: MCEUL-PH
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09180-0402
Practice Address - Country:US
Practice Address - Phone:011491609-136-3467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302028943183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist