Provider Demographics
NPI:1790074045
Name:PERKUCIN, VERA (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:VERA
Middle Name:
Last Name:PERKUCIN
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 NAAMANS RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-2655
Mailing Address - Country:US
Mailing Address - Phone:302-475-4690
Mailing Address - Fax:302-475-6303
Practice Address - Street 1:2080 NAAMANS RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-2655
Practice Address - Country:US
Practice Address - Phone:302-475-4690
Practice Address - Fax:302-475-6303
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0003200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEA1-0003200OtherDELAWARE BOARD OF PHARMACY