Provider Demographics
NPI:1952759136
Name:POUCHAN, DAVID (RPH)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:POUCHAN
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 1:12001 COASTAL HWY
Mailing Address - Street 2:
Mailing Address - City:OCEAN CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21842-4720
Mailing Address - Country:US
Mailing Address - Phone:410-524-5101
Mailing Address - Fax:
Practice Address - Street 1:12001 COASTAL HWY
Practice Address - Street 2:
Practice Address - City:OCEAN CITY
Practice Address - State:MD
Practice Address - Zip Code:21842-4720
Practice Address - Country:US
Practice Address - Phone:410-524-5101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-30
Last Update Date:2016-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15262183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist