Provider Demographics
NPI:1861017345
Name:CHANDLER, ALICE HONG (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ALICE
Middle Name:HONG
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 S 10TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-5608
Mailing Address - Country:US
Mailing Address - Phone:215-465-2130
Mailing Address - Fax:215-465-0899
Practice Address - Street 1:1405 S 10TH ST # AT
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-5608
Practice Address - Country:US
Practice Address - Phone:215-465-2130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP442959183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist