Provider Demographics
NPI:1598954059
Name:PERHACH, MICHAEL M III (RPH)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:M
Last Name:PERHACH
Suffix:III
Gender:M
Credentials:RPH
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Mailing Address - Street 1:33 CHENANGO BRIDGE RD
Mailing Address - Street 2:PRICE CHOPPER PHARMACY 234
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13901-1233
Mailing Address - Country:US
Mailing Address - Phone:607-235-7243
Mailing Address - Fax:607-771-6219
Practice Address - Street 1:33 CHENANGO BRIDGE RD
Practice Address - Street 2:PRICE CHOPPER PHARMACY 234
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13901-1233
Practice Address - Country:US
Practice Address - Phone:770-235-7243
Practice Address - Fax:607-771-6219
Is Sole Proprietor?:No
Enumeration Date:2007-10-22
Last Update Date:2011-11-01
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Provider Licenses
StateLicense IDTaxonomies
NY029636183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist