Provider Demographics
NPI:1134520349
Name:KOVACH, ALEXANDER JOSEPH (RPH)
Entity type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:JOSEPH
Last Name:KOVACH
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 1:115 S PINEY RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:MD
Mailing Address - Zip Code:21619-2619
Mailing Address - Country:US
Mailing Address - Phone:410-643-3001
Mailing Address - Fax:410-643-4210
Practice Address - Street 1:115 S PINEY RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:MD
Practice Address - Zip Code:21619-2619
Practice Address - Country:US
Practice Address - Phone:410-643-3001
Practice Address - Fax:410-643-4210
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-07
Last Update Date:2014-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18410183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist