Provider Demographics
NPI:1003411760
Name:PARKS, CATHERINE JEAN (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:JEAN
Last Name:PARKS
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:DR
Other - First Name:CATHERINE
Other - Middle Name:JEAN
Other - Last Name:OBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD, RPH
Mailing Address - Street 1:7009 HAWTHORN TRCE
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-5353
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19950 DETROIT RD
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-1837
Practice Address - Country:US
Practice Address - Phone:440-356-1999
Practice Address - Fax:440-356-0382
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03237333183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist