Provider Demographics
NPI:1851527634
Name:KATELL, BARRY STEVEN (RPH)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:STEVEN
Last Name:KATELL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:BREVARD
Mailing Address - State:NC
Mailing Address - Zip Code:28712-3179
Mailing Address - Country:US
Mailing Address - Phone:828-884-5412
Mailing Address - Fax:828-884-5530
Practice Address - Street 1:804 N BROAD ST
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-3179
Practice Address - Country:US
Practice Address - Phone:828-884-5412
Practice Address - Fax:828-884-5530
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-06
Last Update Date:2009-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0003512183500000X
TN11493183500000X
NC09837183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist