Provider Demographics
NPI:1821312075
Name:CHAPRNKA, KENNETH DALE (RPH)
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:DALE
Last Name:CHAPRNKA
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 1:5350 LEAVITT RD
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-2158
Mailing Address - Country:US
Mailing Address - Phone:440-282-4570
Mailing Address - Fax:440-282-4630
Practice Address - Street 1:5350 LEAVITT RD
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-2158
Practice Address - Country:US
Practice Address - Phone:440-282-4570
Practice Address - Fax:440-282-4630
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-17
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-14957183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist