Provider Demographics
NPI:1750536231
Name:FABERT, ANITA (RPH)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:FABERT
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 1:17 WILTSHIRE WEST ST
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17015-7101
Mailing Address - Country:US
Mailing Address - Phone:724-599-7412
Mailing Address - Fax:
Practice Address - Street 1:17 WILTSHIRE WEST ST
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17015-7101
Practice Address - Country:US
Practice Address - Phone:724-599-7412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP-036606-L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist