Provider Demographics
NPI:1871193052
Name:CARETTI, DENA (RPH)
Entity Type:Individual
Prefix:
First Name:DENA
Middle Name:
Last Name:CARETTI
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 1:311 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-1211
Mailing Address - Country:US
Mailing Address - Phone:843-290-3201
Mailing Address - Fax:
Practice Address - Street 1:3163 STATE ROUTE 257 STE 1
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:PA
Practice Address - Zip Code:16346-2425
Practice Address - Country:US
Practice Address - Phone:814-677-1408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-28
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP040019L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARPI009353OtherPA AUTHORIZATION TO ADMINISTER INJECTABLES
PARP040019LOtherPHARMACY LICENSE