Provider Demographics
NPI:1871625376
Name:COSCIA, CHARLIE DAVID (PHARM D)
Entity type:Individual
Prefix:
First Name:CHARLIE
Middle Name:DAVID
Last Name:COSCIA
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8419 STRASBOURG CT
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-6742
Mailing Address - Country:US
Mailing Address - Phone:865-357-9372
Mailing Address - Fax:
Practice Address - Street 1:2710 MAYNARDVILLE HWY
Practice Address - Street 2:
Practice Address - City:MAYNARDVILLE
Practice Address - State:TN
Practice Address - Zip Code:37807-3021
Practice Address - Country:US
Practice Address - Phone:865-992-8581
Practice Address - Fax:865-992-2521
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9511183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist