Healthcare Provider Details

I. General information

NPI: 1760603765
Provider Name (Legal Business Name): CHAD ERIC TUCKERMAN PHARM.D., BCPS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 08/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 ARLINGTON AVE
TOLEDO OH
43614-2595
US

IV. Provider business mailing address

7041 CRIMSON CIR
MAUMEE OH
43537-8915
US

V. Phone/Fax

Practice location:
  • Phone: 419-383-3898
  • Fax:
Mailing address:
  • Phone: 419-343-4122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-1-22738
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: