Healthcare Provider Details

I. General information

NPI: 1093703464
Provider Name (Legal Business Name): JUDY ANN KUTCHMAN R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 09/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 BUSINESS CENTER DR SUITE 310
PITTSBURGH PA
15205-1309
US

IV. Provider business mailing address

219 CHURCH DR
CORAOPOLIS PA
15108-3487
US

V. Phone/Fax

Practice location:
  • Phone: 412-505-2176
  • Fax:
Mailing address:
  • Phone: 412-859-1101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP036767L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: