Provider Demographics
NPI:1316024474
Name:KERCHUSKY, CHARLES DAVID (RPH)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:DAVID
Last Name:KERCHUSKY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:32 BROOKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-2056
Mailing Address - Country:US
Mailing Address - Phone:856-582-0681
Mailing Address - Fax:215-468-0175
Practice Address - Street 1:800 MCKEAN ST
Practice Address - Street 2:ZEVIN'S DRUG STORE, INC
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19148-2342
Practice Address - Country:US
Practice Address - Phone:215-468-0622
Practice Address - Fax:215-468-0175
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP030980L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist