Provider Demographics
NPI:1437481777
Name:GRESH, CAROL ANN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CAROL ANN
Middle Name:
Last Name:GRESH
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 1:1702 E 38TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16510-3466
Mailing Address - Country:US
Mailing Address - Phone:814-455-9629
Mailing Address - Fax:814-456-7972
Practice Address - Street 1:1702 E 38TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16510-3466
Practice Address - Country:US
Practice Address - Phone:814-455-9629
Practice Address - Fax:814-456-7972
Is Sole Proprietor?:No
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP030337L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist