Provider Demographics
NPI:1700276250
Name:CRISWELL, SARAH BETH (CPHT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:BETH
Last Name:CRISWELL
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MILL ROAD
Mailing Address - Street 2:PO BOX 985
Mailing Address - City:OAKS
Mailing Address - State:PA
Mailing Address - Zip Code:19456
Mailing Address - Country:US
Mailing Address - Phone:610-650-3927
Mailing Address - Fax:610-783-3203
Practice Address - Street 1:200 MILL ROAD
Practice Address - Street 2:
Practice Address - City:OAKS
Practice Address - State:PA
Practice Address - Zip Code:19456
Practice Address - Country:US
Practice Address - Phone:610-650-3927
Practice Address - Fax:610-783-3203
Is Sole Proprietor?:No
Enumeration Date:2015-02-04
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA470101090253628183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician