Provider Demographics
NPI:1326692039
Name:KUCHAR, TRAVIS V (PHARMD, RP)
Entity Type:Individual
Prefix:
First Name:TRAVIS
Middle Name:V
Last Name:KUCHAR
Suffix:
Gender:M
Credentials:PHARMD, RP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 252
Mailing Address - Street 2:
Mailing Address - City:CENTRAL CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68826-0252
Mailing Address - Country:US
Mailing Address - Phone:308-946-3859
Mailing Address - Fax:308-946-3850
Practice Address - Street 1:1414 16TH ST
Practice Address - Street 2:
Practice Address - City:CENTRAL CITY
Practice Address - State:NE
Practice Address - Zip Code:68826-1812
Practice Address - Country:US
Practice Address - Phone:308-946-3859
Practice Address - Fax:308-946-3850
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-31
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE14546183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist