Healthcare Provider Details

I. General information

NPI: 1922395052
Provider Name (Legal Business Name): DACHUAN CHEN PHARM. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2011
Last Update Date: 07/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 W LANCASTER AVE
ARDMORE PA
19003-1401
US

IV. Provider business mailing address

169 W LANCASTER AVE
ARDMORE PA
19003-1401
US

V. Phone/Fax

Practice location:
  • Phone: 610-649-7150
  • Fax: 610-649-3391
Mailing address:
  • Phone: 610-649-7150
  • Fax: 610-649-3391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP445756
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: