Provider Demographics
NPI:1184228827
Name:CHESLIK, JAMES VINCENT (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:VINCENT
Last Name:CHESLIK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 E MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47302-4063
Mailing Address - Country:US
Mailing Address - Phone:765-288-2157
Mailing Address - Fax:765-284-8818
Practice Address - Street 1:425 E MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47302-4063
Practice Address - Country:US
Practice Address - Phone:765-288-2157
Practice Address - Fax:765-284-8818
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA16130183500000X
IN26092056A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist