Provider Demographics
NPI:1366211229
Name:HO, CHENH TAC
Entity type:Individual
Prefix:
First Name:CHENH
Middle Name:TAC
Last Name:HO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 N JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:IA
Mailing Address - Zip Code:52641-2017
Mailing Address - Country:US
Mailing Address - Phone:319-385-0733
Mailing Address - Fax:319-385-0735
Practice Address - Street 1:210 N JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:IA
Practice Address - Zip Code:52641-2017
Practice Address - Country:US
Practice Address - Phone:319-385-0733
Practice Address - Fax:319-385-0735
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV15469183500000X
IA18814183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist