Provider Demographics
NPI:1831467695
Name:GULLION, CATHERINE H (RPH)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:H
Last Name:GULLION
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 1:4415 DOUGLAS AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310-2717
Mailing Address - Country:US
Mailing Address - Phone:515-279-4739
Mailing Address - Fax:515-279-0254
Practice Address - Street 1:4415 DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-2717
Practice Address - Country:US
Practice Address - Phone:515-279-4739
Practice Address - Fax:515-279-0254
Is Sole Proprietor?:No
Enumeration Date:2011-12-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA17060183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist