Provider Demographics
NPI:1871825943
Name:KOSHKO, NANCY (RPH)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:KOSHKO
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 1:800 CLARMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-5705
Mailing Address - Country:US
Mailing Address - Phone:215-245-1888
Mailing Address - Fax:901-746-4824
Practice Address - Street 1:800 CLARMONT AVE
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-5705
Practice Address - Country:US
Practice Address - Phone:215-245-1888
Practice Address - Fax:901-746-4824
Is Sole Proprietor?:No
Enumeration Date:2010-02-01
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP030694L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist