Provider Demographics
NPI:1285200683
Name:CHIKWANHA, JAMES (PHARMD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:CHIKWANHA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 N 9TH ST STE 3
Mailing Address - Street 2:
Mailing Address - City:STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18360-6501
Mailing Address - Country:US
Mailing Address - Phone:570-476-6936
Mailing Address - Fax:570-476-6938
Practice Address - Street 1:1619 N 9TH ST STE 3
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-6501
Practice Address - Country:US
Practice Address - Phone:570-476-6936
Practice Address - Fax:570-476-6938
Is Sole Proprietor?:No
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP4465551835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA31531464OtherDRIVER LICENSE
PARP446555OtherPA BOARD OF PHARMACY