Provider Demographics
NPI:1720075013
Name:DEITCH, CHRISTOPHER EDWARD (PHARM D)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:EDWARD
Last Name:DEITCH
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20244 BADGER LN
Mailing Address - Street 2:
Mailing Address - City:ONANCOCK
Mailing Address - State:VA
Mailing Address - Zip Code:23417-1238
Mailing Address - Country:US
Mailing Address - Phone:757-535-0347
Mailing Address - Fax:757-824-4011
Practice Address - Street 1:7001 LANKFORD HWY
Practice Address - Street 2:
Practice Address - City:OAK HALL
Practice Address - State:VA
Practice Address - Zip Code:23416-2223
Practice Address - Country:US
Practice Address - Phone:757-824-4477
Practice Address - Fax:757-824-4011
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-01
Last Update Date:2022-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202206621183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist