Provider Demographics
NPI:1285651935
Name:EBERLING, KATHRYN M (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:M
Last Name:EBERLING
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 1:106 DENA ST
Mailing Address - Street 2:
Mailing Address - City:PLENTYWOOD
Mailing Address - State:MT
Mailing Address - Zip Code:59254-2114
Mailing Address - Country:US
Mailing Address - Phone:406-765-2351
Mailing Address - Fax:406-765-1811
Practice Address - Street 1:119 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PLENTYWOOD
Practice Address - State:MT
Practice Address - Zip Code:59254-1817
Practice Address - Country:US
Practice Address - Phone:406-765-1810
Practice Address - Fax:406-765-1811
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT3355183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist