Provider Demographics
NPI:1043975576
Name:SALISBURY, MARY BETH (RPH)
Entity Type:Individual
Prefix:
First Name:MARY BETH
Middle Name:
Last Name:SALISBURY
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 1:606 ERIE ST
Mailing Address - Street 2:
Mailing Address - City:EDINBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16412-6002
Mailing Address - Country:US
Mailing Address - Phone:814-602-0742
Mailing Address - Fax:
Practice Address - Street 1:606 ERIE ST
Practice Address - Street 2:
Practice Address - City:EDINBORO
Practice Address - State:PA
Practice Address - Zip Code:16412-6002
Practice Address - Country:US
Practice Address - Phone:814-734-5036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-31
Last Update Date:2021-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP439726183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist