Provider Demographics
NPI:1417001249
Name:ALT, CALVIN JOSEPH JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:CALVIN
Middle Name:JOSEPH
Last Name:ALT
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 1:581 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-5063
Mailing Address - Country:US
Mailing Address - Phone:410-360-1085
Mailing Address - Fax:
Practice Address - Street 1:228 STRAWBRIDGE DR
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-4600
Practice Address - Country:US
Practice Address - Phone:856-840-4873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD9061183500000X
PARP437499183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist