Provider Demographics
NPI:1225562911
Name:TKACH, TASHA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TASHA
Middle Name:
Last Name:TKACH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 LANCASTER PIKE
Mailing Address - Street 2:
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43113-1840
Mailing Address - Country:US
Mailing Address - Phone:740-477-5763
Mailing Address - Fax:
Practice Address - Street 1:175 LANCASTER PIKE
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-1840
Practice Address - Country:US
Practice Address - Phone:740-477-5763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-19
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03335040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist