Provider Demographics
NPI:1073808986
Name:WOODS, CORINNE M (RPH)
Entity Type:Individual
Prefix:MS
First Name:CORINNE
Middle Name:M
Last Name:WOODS
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 1:1240 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-2911
Mailing Address - Country:US
Mailing Address - Phone:619-213-0000
Mailing Address - Fax:619-213-0000
Practice Address - Street 1:1240 BROADWAY
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-2911
Practice Address - Country:US
Practice Address - Phone:619-213-0000
Practice Address - Fax:619-213-0000
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48652183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist