Provider Demographics
NPI:1740559582
Name:RITENOUR, BETH PAULA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:PAULA
Last Name:RITENOUR
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 1:2 SOUTHMINISTER CT
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-3948
Mailing Address - Country:US
Mailing Address - Phone:850-502-9208
Mailing Address - Fax:
Practice Address - Street 1:414 MARY ESTHER CUTOFF NW
Practice Address - Street 2:C
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32548
Practice Address - Country:US
Practice Address - Phone:850-244-0869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-23
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS33270183500000X
MA22106183500000X
VA0202011663183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist