Provider Demographics
NPI:1912311622
Name:DODD, CALEB (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CALEB
Middle Name:
Last Name:DODD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 BEAR ST
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:16262-2613
Mailing Address - Country:US
Mailing Address - Phone:724-991-1241
Mailing Address - Fax:
Practice Address - Street 1:200 GREATER BUTLER MART
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-3283
Practice Address - Country:US
Practice Address - Phone:724-282-7808
Practice Address - Fax:724-282-0768
Is Sole Proprietor?:No
Enumeration Date:2014-06-20
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP443821183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist