Provider Demographics
NPI:1679186787
Name:PERRY, KATHERINE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:
Last Name:PERRY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:WOODARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 662
Mailing Address - Street 2:
Mailing Address - City:CEDARVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45314-0662
Mailing Address - Country:US
Mailing Address - Phone:937-766-2273
Mailing Address - Fax:
Practice Address - Street 1:63 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CEDARVILLE
Practice Address - State:OH
Practice Address - Zip Code:45314-8637
Practice Address - Country:US
Practice Address - Phone:937-766-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03438780183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist