Provider Demographics
NPI:1801066915
Name:KOSCH, WILLIAM R (RPH)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:R
Last Name:KOSCH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1127 BRYN MAWR AVE
Mailing Address - Street 2:STE A
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-4558
Mailing Address - Country:US
Mailing Address - Phone:800-225-5967
Mailing Address - Fax:909-799-4364
Practice Address - Street 1:1127 BRYN MAWR AVE
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-4558
Practice Address - Country:US
Practice Address - Phone:800-225-5967
Practice Address - Fax:909-799-6462
Is Sole Proprietor?:No
Enumeration Date:2008-03-04
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36426183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist