Provider Demographics
NPI:1811584097
Name:COLEMAN, KATHARINE ANN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KATHARINE
Middle Name:ANN
Last Name:COLEMAN
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 1:23 KILLINGWORTH RD
Mailing Address - Street 2:
Mailing Address - City:HIGGANUM
Mailing Address - State:CT
Mailing Address - Zip Code:06441-4242
Mailing Address - Country:US
Mailing Address - Phone:860-345-2141
Mailing Address - Fax:860-345-3611
Practice Address - Street 1:23 KILLINGWORTH RD
Practice Address - Street 2:
Practice Address - City:HIGGANUM
Practice Address - State:CT
Practice Address - Zip Code:06441-4242
Practice Address - Country:US
Practice Address - Phone:860-345-3607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8312183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist