Provider Demographics
NPI:1710278221
Name:BITTORF, KARETHA PEARL (RPH, PHARM D)
Entity Type:Individual
Prefix:DR
First Name:KARETHA
Middle Name:PEARL
Last Name:BITTORF
Suffix:
Gender:F
Credentials:RPH, PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1902 MOUNT RUSHMORE RD
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-4621
Mailing Address - Country:US
Mailing Address - Phone:605-342-0194
Mailing Address - Fax:605-342-8294
Practice Address - Street 1:1902 MOUNT RUSHMORE RD
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-4621
Practice Address - Country:US
Practice Address - Phone:605-342-0194
Practice Address - Fax:605-342-8294
Is Sole Proprietor?:No
Enumeration Date:2011-05-02
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD5081183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist