Provider Demographics
NPI:1255869798
Name:WING, BETH (RPH)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:WING
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 1:1971 BREED HILL CT
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-1202
Mailing Address - Country:US
Mailing Address - Phone:740-654-6542
Mailing Address - Fax:
Practice Address - Street 1:1971 BREED HILL CT
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-1202
Practice Address - Country:US
Practice Address - Phone:740-654-6542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03118886183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist