Provider Demographics
NPI:1285492744
Name:WELBY, GRETCHEN (PHARMD)
Entity type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:
Last Name:WELBY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1761 CAPOUSE AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18509-1974
Mailing Address - Country:US
Mailing Address - Phone:570-881-3921
Mailing Address - Fax:
Practice Address - Street 1:1761 CAPOUSE AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18509-1974
Practice Address - Country:US
Practice Address - Phone:570-881-3921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP038941L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist