Provider Demographics
NPI:1932295623
Name:CALLAHAN, PATRICIA POMEROY (RPH)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:POMEROY
Last Name:CALLAHAN
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 1:100 SOUTH ROAD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03037
Mailing Address - Country:US
Mailing Address - Phone:603-463-7670
Mailing Address - Fax:
Practice Address - Street 1:VA MEDICAL CENTER
Practice Address - Street 2:718 SMYTH ROAD
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104
Practice Address - Country:US
Practice Address - Phone:603-624-4366
Practice Address - Fax:603-626-6562
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT27141835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy