Provider Demographics
NPI:1346672052
Name:KARDOS, NELSON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NELSON
Middle Name:
Last Name:KARDOS
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 1:138 BEACON STREET
Mailing Address - Street 2:
Mailing Address - City:COATESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320
Mailing Address - Country:US
Mailing Address - Phone:610-256-2654
Mailing Address - Fax:
Practice Address - Street 1:138 BEACON STREET
Practice Address - Street 2:
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320
Practice Address - Country:US
Practice Address - Phone:610-256-2654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-05
Last Update Date:2014-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP445050183500000X
DEA1-0004126183500000X
MD20017183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist