Provider Demographics
NPI:1851593693
Name:DELGANDIO, ALFRED ANTHONY JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:ALFRED
Middle Name:ANTHONY
Last Name:DELGANDIO
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:177 MAPLEMERE DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-3556
Mailing Address - Country:US
Mailing Address - Phone:931-920-2500
Mailing Address - Fax:931-920-2500
Practice Address - Street 1:2109 WILMA RUDOLPH BLVD
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-6663
Practice Address - Country:US
Practice Address - Phone:931-551-8157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN011956183500000X
CT05721183500000X
KY011143183500000X
NY032438183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist