Provider Demographics
NPI:1467055962
Name:CHHIBBA, HARISH
Entity Type:Individual
Prefix:
First Name:HARISH
Middle Name:
Last Name:CHHIBBA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 WHITE CLAY TER
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-3017
Mailing Address - Country:US
Mailing Address - Phone:302-650-0040
Mailing Address - Fax:
Practice Address - Street 1:11 N DUPONT HWY
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-4260
Practice Address - Country:US
Practice Address - Phone:302-672-7010
Practice Address - Fax:302-672-7062
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA10005018183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist