Provider Demographics
NPI:1871900449
Name:ANATO, SETH (PHARMD)
Entity type:Individual
Prefix:
First Name:SETH
Middle Name:
Last Name:ANATO
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 1:404 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:GLEN CARBON
Mailing Address - State:IL
Mailing Address - Zip Code:62034-2734
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 PROFESSIONAL DR STE 170
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-5069
Practice Address - Country:US
Practice Address - Phone:618-463-0000
Practice Address - Fax:618-463-0008
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-16
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013042272183500000X
IL051.296965183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist