Provider Demographics
NPI:1003198730
Name:LEWIS, KARA A (PHARMD)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:A
Last Name:LEWIS
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 1:134 STATE ST
Mailing Address - Street 2:WALGREENS PHARMACY
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06450-3293
Mailing Address - Country:US
Mailing Address - Phone:203-634-3241
Mailing Address - Fax:203-634-3253
Practice Address - Street 1:134 STATE ST
Practice Address - Street 2:WALGREENS PHARMACY
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06450-3293
Practice Address - Country:US
Practice Address - Phone:203-634-3241
Practice Address - Fax:203-634-3253
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT104081835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist