Provider Demographics
NPI:1396840815
Name:FREEDMAN, CALVIN A (RPH)
Entity Type:Individual
Prefix:
First Name:CALVIN
Middle Name:A
Last Name:FREEDMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 LARK DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-1216
Mailing Address - Country:US
Mailing Address - Phone:302-368-8192
Mailing Address - Fax:302-368-4877
Practice Address - Street 1:31 ALBE DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-1360
Practice Address - Country:US
Practice Address - Phone:302-369-5520
Practice Address - Fax:302-369-5853
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0001537183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist