Provider Demographics
NPI:1194163428
Name:CLENDENIN, CHARLES (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:
Last Name:CLENDENIN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 SCOTLAND RD
Mailing Address - Street 2:
Mailing Address - City:QUARRYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17566-9238
Mailing Address - Country:US
Mailing Address - Phone:717-989-5819
Mailing Address - Fax:
Practice Address - Street 1:702 EDGEWOOD RD
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:MD
Practice Address - Zip Code:21040-2400
Practice Address - Country:US
Practice Address - Phone:410-671-9780
Practice Address - Fax:410-671-6534
Is Sole Proprietor?:No
Enumeration Date:2013-06-09
Last Update Date:2013-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD21145183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist