Provider Demographics
NPI:1083077788
Name:WERHUN, MARY ERIN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MARY ERIN
Middle Name:
Last Name:WERHUN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MISS
Other - First Name:MARY ERIN
Other - Middle Name:
Other - Last Name:JANUSZESKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:207 WILLOW RD
Mailing Address - Street 2:
Mailing Address - City:PITTSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18640-3759
Mailing Address - Country:US
Mailing Address - Phone:570-655-0216
Mailing Address - Fax:
Practice Address - Street 1:207 WILLOW RD
Practice Address - Street 2:
Practice Address - City:PITTSTON
Practice Address - State:PA
Practice Address - Zip Code:18640-3759
Practice Address - Country:US
Practice Address - Phone:570-655-0216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP039028L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist