Provider Demographics
NPI:1760509046
Name:MURR, THEODORE (RPH)
Entity Type:Individual
Prefix:
First Name:THEODORE
Middle Name:
Last Name:MURR
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 SUMMIT HOUSE
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-6518
Mailing Address - Country:US
Mailing Address - Phone:610-719-8644
Mailing Address - Fax:
Practice Address - Street 1:1812 MARSH RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4581
Practice Address - Country:US
Practice Address - Phone:302-475-4265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA10002601183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist