Provider Demographics
NPI:1689852451
Name:SALSTROM, CAROLINE J (RPH)
Entity Type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:J
Last Name:SALSTROM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:900 AVENIDA ACASO
Mailing Address - Street 2:SUITE A
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-8749
Mailing Address - Country:US
Mailing Address - Phone:805-388-9336
Mailing Address - Fax:805-482-6324
Practice Address - Street 1:900 AVENIDA ACASO
Practice Address - Street 2:SUITE A
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-8749
Practice Address - Country:US
Practice Address - Phone:805-388-9336
Practice Address - Fax:805-482-6324
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-04
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORRPH-0011659183500000X
CA43162183500000X
AZ8721183500000X
KY015237183500000X
VA0202209798183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist