Provider Demographics
NPI:1609182559
Name:ALDERFER, R. KENNETH JR
Entity Type:Individual
Prefix:MR
First Name:R.
Middle Name:KENNETH
Last Name:ALDERFER
Suffix:JR
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 1:86 COLLINS LN
Mailing Address - Street 2:
Mailing Address - City:SCHWENKSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19473-1661
Mailing Address - Country:US
Mailing Address - Phone:610-287-4384
Mailing Address - Fax:
Practice Address - Street 1:86 COLLINS LN
Practice Address - Street 2:
Practice Address - City:SCHWENKSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19473-1661
Practice Address - Country:US
Practice Address - Phone:610-287-4384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-28
Last Update Date:2010-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP027227L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist