Provider Demographics
NPI:1841793379
Name:CHINN, ANDREW HOWARD (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:HOWARD
Last Name:CHINN
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 FILES RD
Mailing Address - Street 2:
Mailing Address - City:GORHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04038-2115
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 TRAP FALLS ROAD EXT
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-4646
Practice Address - Country:US
Practice Address - Phone:203-683-9257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-11
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR47111183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist