Provider Demographics
NPI:1669510681
Name:GATHAGAN, KAREN L (RPH)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:L
Last Name:GATHAGAN
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 1:302 OAKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PHILIPSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16866-8700
Mailing Address - Country:US
Mailing Address - Phone:814-343-4766
Mailing Address - Fax:814-343-4754
Practice Address - Street 1:302 OAKWOOD DR
Practice Address - Street 2:
Practice Address - City:PHILIPSBURG
Practice Address - State:PA
Practice Address - Zip Code:16866-8700
Practice Address - Country:US
Practice Address - Phone:814-343-4766
Practice Address - Fax:814-343-4754
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP034694L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist