Provider Demographics
NPI:1902524390
Name:AL DAHAN, TAMARA (RPH)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:AL DAHAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 UPLAND SQ DR
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-5174
Mailing Address - Country:US
Mailing Address - Phone:484-654-3581
Mailing Address - Fax:484-654-3591
Practice Address - Street 1:100 UPLAND SQ DR
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-5174
Practice Address - Country:US
Practice Address - Phone:484-654-3581
Practice Address - Fax:484-654-3591
Is Sole Proprietor?:No
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP456537183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0OtherCVS RETAIL PHARMACY