1023826393 NPI number — TIFFANY E. CHAMBERS NP

Table of content: JEANNIE Y SMITH PHARMD (NPI 1386339067)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023826393 NPI number — TIFFANY E. CHAMBERS NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHAMBERS
Provider First Name:
TIFFANY
Provider Middle Name:
E.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PEOPLES
Provider Other First Name:
TIFFANY
Provider Other Middle Name:
E.
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1023826393
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/25/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12380 PLAZA DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PARMA
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44130-1043
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-898-8488
Provider Business Mailing Address Fax Number:
216-362-0677

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12380 PLAZA DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PARMA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44130-1043
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-898-8488
Provider Business Practice Location Address Fax Number:
216-362-0677
Provider Enumeration Date:
12/19/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2200X , with the licence number:  333497 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LG0600X , with the licence number: 333497 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP2300X , with the licence number: 333497 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LA2200X , with the licence number: 0039531 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)