Provider Demographics
NPI:1649912767
Name:HADUCK, MADISON (PHARMD)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:HADUCK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:PA
Mailing Address - Zip Code:18517-1917
Mailing Address - Country:US
Mailing Address - Phone:570-561-7460
Mailing Address - Fax:
Practice Address - Street 1:509 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:PA
Practice Address - Zip Code:18517-1917
Practice Address - Country:US
Practice Address - Phone:570-561-7460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-09
Last Update Date:2022-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP456628183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist