Provider Demographics
NPI:1407154230
Name:D'ARDENNE, CHARLES H JR (RPH)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:H
Last Name:D'ARDENNE
Suffix:JR
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 1:1244 ALEXANDER DR
Mailing Address - Street 2:
Mailing Address - City:HATFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19440-3461
Mailing Address - Country:US
Mailing Address - Phone:610-630-0882
Mailing Address - Fax:
Practice Address - Street 1:2775 W MAIN ST
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19403-1611
Practice Address - Country:US
Practice Address - Phone:610-630-0882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP031135L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP031135LOtherSTATE