Provider Demographics
NPI:1629961313
Name:DODGE, CALEIGH (RPH)
Entity type:Individual
Prefix:
First Name:CALEIGH
Middle Name:
Last Name:DODGE
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 1:164 BARNES RD
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06795-3004
Mailing Address - Country:US
Mailing Address - Phone:203-841-8311
Mailing Address - Fax:
Practice Address - Street 1:164 BARNES RD
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:CT
Practice Address - Zip Code:06795-3004
Practice Address - Country:US
Practice Address - Phone:203-841-8311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-31
Last Update Date:2025-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCPH.60589183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist