Provider Demographics
NPI:1538609730
Name:WEBER, BETH W (RPH)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:W
Last Name:WEBER
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 1:859 IVY LN
Mailing Address - Street 2:
Mailing Address - City:DALEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24083-3600
Mailing Address - Country:US
Mailing Address - Phone:540-314-9621
Mailing Address - Fax:540-981-7236
Practice Address - Street 1:859 IVY LN
Practice Address - Street 2:
Practice Address - City:DALEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24083-3600
Practice Address - Country:US
Practice Address - Phone:540-314-9621
Practice Address - Fax:540-981-7236
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-07
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202010130183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist