Provider Demographics
NPI:1578840930
Name:SMITH, CATHERINE M (RPH)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:M
Last Name:SMITH
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 1:32979 COASTAL HWY
Mailing Address - Street 2:
Mailing Address - City:BETHANY BEACH
Mailing Address - State:DE
Mailing Address - Zip Code:19930-3752
Mailing Address - Country:US
Mailing Address - Phone:302-537-3700
Mailing Address - Fax:302-537-3704
Practice Address - Street 1:32979 COASTAL HWY
Practice Address - Street 2:
Practice Address - City:BETHANY BEACH
Practice Address - State:DE
Practice Address - Zip Code:19930-3752
Practice Address - Country:US
Practice Address - Phone:302-537-3700
Practice Address - Fax:302-537-3704
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-12
Last Update Date:2011-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0002984183500000X
OK12005183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist