Provider Demographics
NPI:1093922452
Name:CHOATE, KATHERINE SUE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:SUE
Last Name:CHOATE
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 1:1515 W BELL ST
Mailing Address - Street 2:
Mailing Address - City:GLENDIVE
Mailing Address - State:MT
Mailing Address - Zip Code:59330-3240
Mailing Address - Country:US
Mailing Address - Phone:406-365-9642
Mailing Address - Fax:406-365-9866
Practice Address - Street 1:1515 W BELL ST
Practice Address - Street 2:
Practice Address - City:GLENDIVE
Practice Address - State:MT
Practice Address - Zip Code:59330-3240
Practice Address - Country:US
Practice Address - Phone:406-365-9642
Practice Address - Fax:406-365-9866
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR8908183500000X
MT3423183500000X
ND5162183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist