Provider Demographics
NPI:1205355922
Name:DOUGLAS, DEBORAH KATHIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:KATHIE
Last Name:DOUGLAS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 WATCH HILL RD
Mailing Address - Street 2:
Mailing Address - City:EAST FALLOWFIELD TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:19320-3955
Mailing Address - Country:US
Mailing Address - Phone:484-786-8370
Mailing Address - Fax:
Practice Address - Street 1:3807 W LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-2216
Practice Address - Country:US
Practice Address - Phone:610-269-0226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-13
Last Update Date:2017-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARPI011781183500000X
PARP451934183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist