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General NPI Number Information
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NPI Number | 1790091742
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Entity Type | Individual
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Provider Name | ALTON TYRONE CHATMON SR. PHARM. D.
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Gender | Male
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Dates
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Enumeration Date | 08/27/2010
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Last Update Date | 04/01/2012
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Provider Practice Location Address
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Address Line | 515 E LANDIS AVE
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City | VINELAND
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State | NJ
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Zip | 08360-8003
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Country | US
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Telephone | 856-691-8100
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Fax |
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Provider Business Mailing Address
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Address Line | 490 BIG OAK RD
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City | BRIDGETON
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State | NJ
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Zip | 08302-4919
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Country | US
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Telephone | 856-896-0056
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28RI02691200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | A1-0003048
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License Number State | DE
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