Provider Demographics
NPI:1093486367
Name:BODENSCHATZ, BETH ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:ANN
Last Name:BODENSCHATZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:881 HILLS PLZ
Mailing Address - Street 2:
Mailing Address - City:EBENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15931-4213
Mailing Address - Country:US
Mailing Address - Phone:814-472-0614
Mailing Address - Fax:814-472-7088
Practice Address - Street 1:881 HILLS PLZ
Practice Address - Street 2:
Practice Address - City:EBENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15931-4213
Practice Address - Country:US
Practice Address - Phone:814-472-0614
Practice Address - Fax:814-472-7088
Is Sole Proprietor?:No
Enumeration Date:2021-09-25
Last Update Date:2021-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP440177183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist