Provider Demographics
NPI:1083755045
Name:CALABRETTA, SALVATORE (RPH)
Entity Type:Individual
Prefix:
First Name:SALVATORE
Middle Name:
Last Name:CALABRETTA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-4909
Mailing Address - Country:US
Mailing Address - Phone:330-821-1780
Mailing Address - Fax:
Practice Address - Street 1:475 E STATE ST
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-4909
Practice Address - Country:US
Practice Address - Phone:330-821-1780
Practice Address - Fax:330-821-8045
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-11833183500000X
332B00000X
OH333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3643839OtherNPCDP
OH0591088Medicaid
3643839OtherNPCDP