Provider Demographics
NPI:1871712794
Name:GREENE, ANN MARIE
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:MARIE
Last Name:GREENE
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 1:220 NEW FURNACE RD
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19362-9614
Mailing Address - Country:US
Mailing Address - Phone:610-932-5033
Mailing Address - Fax:
Practice Address - Street 1:220 NEW FURNACE RD
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:PA
Practice Address - Zip Code:19362-9614
Practice Address - Country:US
Practice Address - Phone:610-932-5033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP038480L183500000X
MD14899183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist