MR. KIM E. TILLERY (NPI# 1508096777) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1508096777 |
Entity Type | Individual |
Full Name | MR. KIM E. TILLERY |
Credential | RPH |
Practice Address |
2638 Longbow Dr Twin Falls ID 83301-8946 |
Practice Telephone | 2087354076 |
Practice Fax Number | 2083244599 |
Mailing Telephone | 2087354076 |
Mailing Fax Number | 2083244599 |
Enumeration Date | 2009-07-21 |
Last Update Date | 2009-07-21 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
P4585 | ID | Pharmacy Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467599159 | Kim L Tillery | Audiologist-Hearing Aid Fitter | 280 Central Ave, Suny At Fredonia, Fredonia, NY 14063-1127 | 2007-01-31 |
Street Address |
2638 LONGBOW DR |
City | TWIN FALLS |
State | ID |
Zip Code | 83301-8946 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023645918 | Matthew Anderson | Pharmacist | Dick's Pharmacy, 526 K Shoup Ave W, Twin Falls, ID 83301 | 2020-03-23 |
1780146316 | Frontier Pediatric Partners, Pllc | Pediatrics | 1502 Locust Street N #700, Twin Falls, ID 83301 | 2019-04-02 |
1972073377 | Wood River Acupuncture | Acupuncturist | 1625 Addison Ave East, Twin Falls, ID 83301 | 2018-11-28 |
1235629874 | Lonnie Paul | Counselor | 1092 Eastland Dr N Ste A, Twin Falls, ID 83301 | 2018-05-17 |
1679060966 | Christina Jirapha Thongdee | Social Worker | 625 Poleline Road West, Suite 2a, Twin Falls, ID 83301 | 2018-04-23 |
1437658499 | Tyrel Kevin Ward | Chiropractor | 2167 Village Park Ave., Suite 100, Twin Falls, ID 83301 | 2018-02-06 |
1851836381 | Tanabell Health Services, Inc | Skilled Nursing Facility | 1134 Cheney Drive West, Twin Falls, ID 83301 | 2016-12-19 |
1578005195 | Matthew Carter | Physical Therapist | 1053 Eastland Drive, Twin Falls, ID 83301 | 2016-11-14 |
1790227783 | Murvat Usmanova | Nurse Practitioner | 775 Pole Line Road W, Suite 203, Twin Falls, ID 83301 | 2016-11-08 |
1265894687 | Shawna Fultz | Social Worker | 1201 Fall Ave East Suite C, Twin Falls, ID 83301 | 2016-03-24 |
Find all providers in zip 83301 |
Taxonomy Code | 1835P0018X |
Grouping | Pharmacy Service Providers |
Classification | Pharmacist |
Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023645918 | Matthew Anderson | Pharmacist | Dick's Pharmacy, 526 K Shoup Ave W, Twin Falls, ID 83301 | 2020-03-23 |
1003100116 | Tony Dean Rost | Pharmacist | 1611 Blue Lakes Blvd N, Twin Falls, ID 83301-3374 | 2011-06-06 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417595067 | Teresa Janeen Newsom | Pharmacist | 2840 S Swallowtail Ln, Boise, ID 83706-6138 | 2019-12-13 |
1255714879 | Kristin Helmboldt | Pharmacist | 2309 E Cyanite Dr, Meridian, ID 83642-9072 | 2015-07-01 |
1932480431 | Amy Anne Mcdougal | Pharmacist | 1066 N Yellowstone Hwy, Rexburg, ID 83440-5103 | 2011-08-30 |
1932496650 | Charlotte Loring | Pharmacist | 909 E Park Center B;vd, Boise, ID 83706 | 2011-07-01 |
1215237144 | Jacqueline K Kavila | Pharmacist | 2809 E. Cleveland Blvd, Caldwell, ID 83605 | 2010-10-26 |
1093314866 | Gregory Aaron Carter | Pharmacist | 2327 Coronado St, Idaho Falls, ID 83404-7407 | 2020-10-22 |
1316544604 | James K Hunter | Pharmacist | 301 Aspen Sq, Saint Anthony, ID 83445-1662 | 2020-10-08 |
1629689799 | Tanna Marie Schlader | Pharmacist | 50 2nd St S, Nampa, ID 83651-3700 | 2020-08-12 |
1184233579 | Kathlene Elizabeth Bailey | Pharmacist | 3050 E Mullan Ave, Post Falls, ID 83854-8939 | 2020-07-30 |
1609414051 | Troy M Jackman | Pharmacist | 709 N Lincoln Ave, Jerome, ID 83338-1851 | 2019-12-17 |
Find all providers with the same taxonomy |
City | TWIN FALLS |
Zip Code | 83301 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.