Healthcare Provider Details

I. General information

NPI: 1053312405
Provider Name (Legal Business Name): BETTY L UREY CPHT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 LOCUST ST
COLUMBIA PA
17512-1110
US

IV. Provider business mailing address

427 W BEAVER ST
HELLAM PA
17406-1205
US

V. Phone/Fax

Practice location:
  • Phone: 717-684-2551
  • Fax: 717-684-6239
Mailing address:
  • Phone: 717-755-0969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number030107192629127
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: