Provider Demographics
NPI:1255602314
Name:KUCHTA, ROMANA ANDREA (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:ROMANA
Middle Name:ANDREA
Last Name:KUCHTA
Suffix:
Gender:F
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 1:9144 E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44023-2745
Mailing Address - Country:US
Mailing Address - Phone:440-668-8265
Mailing Address - Fax:
Practice Address - Street 1:22401 LAKE SHORE BLVD
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44123-1312
Practice Address - Country:US
Practice Address - Phone:216-261-4497
Practice Address - Fax:216-261-5138
Is Sole Proprietor?:No
Enumeration Date:2012-01-21
Last Update Date:2012-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03328998183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist