Provider Demographics
NPI:1164408753
Name:WILLIAMSON, CATHERINE MARY (BS IN PHARMACY)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:MARY
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:BS IN PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10966 COUNTY ROAD 14
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:IN
Mailing Address - Zip Code:46540-9605
Mailing Address - Country:US
Mailing Address - Phone:574-825-7043
Mailing Address - Fax:260-768-7832
Practice Address - Street 1:CORNER OF MAIN ST. & MORTON ST.
Practice Address - Street 2:
Practice Address - City:SHIPSHEWANA
Practice Address - State:IN
Practice Address - Zip Code:46565-0155
Practice Address - Country:US
Practice Address - Phone:260-768-4882
Practice Address - Fax:260-768-7832
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26016215A183500000X
MA17800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist