Provider Demographics
NPI:1730358177
Name:MEWHERTER, ANN M (RPH)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:MEWHERTER
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 1:10 DEWBERRY DR
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08610-1312
Mailing Address - Country:US
Mailing Address - Phone:609-585-7062
Mailing Address - Fax:
Practice Address - Street 1:130 WHITE HORSE PIKE N
Practice Address - Street 2:
Practice Address - City:LAWNSIDE
Practice Address - State:NJ
Practice Address - Zip Code:08045-1128
Practice Address - Country:US
Practice Address - Phone:856-546-5111
Practice Address - Fax:856-672-9346
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28 RI 02164700183500000X
PARP 027689 L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RI02164700OtherNJ RPH STATE LICENSE NUM
PARP 027689LOtherPA RPH STATE LICENSE NUM