Provider Demographics
NPI:1134778251
Name:THORNTON, ANNA (RPH, PHARMD)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:THORNTON
Suffix:
Gender:F
Credentials:RPH, PHARMD
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:WOLGAMUTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH, PHARMD
Mailing Address - Street 1:EPHRATA OUTPATIENT PHARMACY-WELLSPAN
Mailing Address - Street 2:183 N. READING ROAD, SUITE 9
Mailing Address - City:EPHRATA
Mailing Address - State:PA
Mailing Address - Zip Code:17522
Mailing Address - Country:US
Mailing Address - Phone:717-885-3639
Mailing Address - Fax:
Practice Address - Street 1:EPHRATA OUTPATIENT PHARMACY-WELLSPAN
Practice Address - Street 2:183 N. READING ROAD, SUITE 9
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522
Practice Address - Country:US
Practice Address - Phone:717-885-3639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP042012L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist