Provider Demographics
NPI:1235529181
Name:VALENTIN, BETHANY CARTER
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:CARTER
Last Name:VALENTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 W DEKALB PIKE
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-2327
Mailing Address - Country:US
Mailing Address - Phone:610-312-0057
Mailing Address - Fax:
Practice Address - Street 1:160 W DEKALB PIKE
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-2327
Practice Address - Country:US
Practice Address - Phone:610-312-0057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-30
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician