Provider Demographics
NPI:1710685813
Name:FISCHER, CHARLES I
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:I
Last Name:FISCHER
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 1:2801 EGYPT RD
Mailing Address - Street 2:
Mailing Address - City:AUDUBON
Mailing Address - State:PA
Mailing Address - Zip Code:19403-2105
Mailing Address - Country:US
Mailing Address - Phone:610-666-0512
Mailing Address - Fax:610-666-0736
Practice Address - Street 1:2801 EGYPT RD
Practice Address - Street 2:
Practice Address - City:AUDUBON
Practice Address - State:PA
Practice Address - Zip Code:19403-2105
Practice Address - Country:US
Practice Address - Phone:610-666-0512
Practice Address - Fax:610-666-0736
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP035301L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist