Provider Demographics
NPI:1649740275
Name:WILTON, ANNA MARIA (RPH)
Entity Type:Individual
Prefix:
First Name:ANNA MARIA
Middle Name:
Last Name:WILTON
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 1:2435 GALLOWS HILL RD
Mailing Address - Street 2:
Mailing Address - City:KINTNERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18930
Mailing Address - Country:US
Mailing Address - Phone:610-346-1647
Mailing Address - Fax:
Practice Address - Street 1:3011 WILLIAM PENN HWY
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045
Practice Address - Country:US
Practice Address - Phone:610-923-7932
Practice Address - Fax:610-923-6081
Is Sole Proprietor?:No
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP042005L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist