Provider Demographics
NPI:1083601215
Name:CHAN, MAGGIE W K (PHARMACIST)
Entity Type:Individual
Prefix:MRS
First Name:MAGGIE
Middle Name:W K
Last Name:CHAN
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 COUNTRY PLACE DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-7110
Mailing Address - Country:US
Mailing Address - Phone:717-898-6375
Mailing Address - Fax:717-898-6375
Practice Address - Street 1:335 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEOLA
Practice Address - State:PA
Practice Address - Zip Code:17540-2107
Practice Address - Country:US
Practice Address - Phone:717-656-3784
Practice Address - Fax:717-656-8388
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP029376L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist