Provider Demographics
NPI:1598225385
Name:HERBERT, SOPHIA MARIE COTHREL (PHARMD)
Entity Type:Individual
Prefix:
First Name:SOPHIA
Middle Name:MARIE COTHREL
Last Name:HERBERT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:SOPHIA
Other - Middle Name:MARIE
Other - Last Name:COTHREL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7038 MEADE PL
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15208-2429
Mailing Address - Country:US
Mailing Address - Phone:317-626-2416
Mailing Address - Fax:
Practice Address - Street 1:5607 BAUM BLVD RM 303
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-3701
Practice Address - Country:US
Practice Address - Phone:317-626-2416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2021-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPI119446183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist