Provider Demographics
NPI:1912502261
Name:ASHMORE, MARITA (RPH)
Entity Type:Individual
Prefix:
First Name:MARITA
Middle Name:
Last Name:ASHMORE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:MARITA
Other - Middle Name:
Other - Last Name:DUGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:813 BREEZEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GLENSHAW
Mailing Address - State:PA
Mailing Address - Zip Code:15116-1509
Mailing Address - Country:US
Mailing Address - Phone:412-580-7930
Mailing Address - Fax:
Practice Address - Street 1:813 BREEZEWOOD DR
Practice Address - Street 2:
Practice Address - City:GLENSHAW
Practice Address - State:PA
Practice Address - Zip Code:15116-1509
Practice Address - Country:US
Practice Address - Phone:412-580-7930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP031428L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist