Provider Demographics
NPI:1033769831
Name:PRIMROSE, CATHERINE ANN (RPH)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANN
Last Name:PRIMROSE
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 1:885 E US HIGHWAY 60
Mailing Address - Street 2:
Mailing Address - City:MONETT
Mailing Address - State:MO
Mailing Address - Zip Code:65708-9367
Mailing Address - Country:US
Mailing Address - Phone:417-235-5980
Mailing Address - Fax:417-235-5627
Practice Address - Street 1:885 E US HIGHWAY 60
Practice Address - Street 2:
Practice Address - City:MONETT
Practice Address - State:MO
Practice Address - Zip Code:65708-9367
Practice Address - Country:US
Practice Address - Phone:417-235-5980
Practice Address - Fax:417-235-5627
Is Sole Proprietor?:No
Enumeration Date:2019-09-13
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0419451835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care