Provider Demographics
NPI:1578182382
Name:KWACHUH, EUGENE TENKANG (PHARMD)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:TENKANG
Last Name:KWACHUH
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 1:423 WYATT DR
Mailing Address - Street 2:
Mailing Address - City:TOWNSEND
Mailing Address - State:DE
Mailing Address - Zip Code:19734-2813
Mailing Address - Country:US
Mailing Address - Phone:502-319-1818
Mailing Address - Fax:
Practice Address - Street 1:723 N BRIDGE ST
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5309
Practice Address - Country:US
Practice Address - Phone:410-392-2961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-11
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21606183500000X
DEA1-0005114183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist