Provider Demographics
NPI:1194038042
Name:KOHLERT-SCHUPP, CLAUDIA (PHD, RPH)
Entity Type:Individual
Prefix:DR
First Name:CLAUDIA
Middle Name:
Last Name:KOHLERT-SCHUPP
Suffix:
Gender:F
Credentials:PHD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:548 S MARINE CORPS DR
Mailing Address - Street 2:FHP HEALTH CENTER
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96913-3539
Mailing Address - Country:US
Mailing Address - Phone:671-646-5825
Mailing Address - Fax:671-647-3598
Practice Address - Street 1:548 S MARINE CORPS DR
Practice Address - Street 2:FHP HEALTH CENTER
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913-3539
Practice Address - Country:US
Practice Address - Phone:671-646-5825
Practice Address - Fax:671-647-3598
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60020056183500000X
GUPH01521835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No183500000XPharmacy Service ProvidersPharmacist