Provider Demographics
NPI:1740025709
Name:SALANIO, GHENELLA MARIE
Entity type:Individual
Prefix:
First Name:GHENELLA MARIE
Middle Name:
Last Name:SALANIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2061 N CHESTER ST
Mailing Address - Street 2:APT 1217
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80010
Mailing Address - Country:US
Mailing Address - Phone:219-218-6796
Mailing Address - Fax:
Practice Address - Street 1:12850 E MONTVIEW BLVD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2605
Practice Address - Country:US
Practice Address - Phone:219-218-6796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS65913183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist