Provider Demographics
NPI:1831406602
Name:WOLFSON, KAREN BETH (RPH,BS,BS)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:BETH
Last Name:WOLFSON
Suffix:
Gender:F
Credentials:RPH,BS,BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 RICKER RD
Mailing Address - Street 2:
Mailing Address - City:BRYANT POND
Mailing Address - State:ME
Mailing Address - Zip Code:04219-6202
Mailing Address - Country:US
Mailing Address - Phone:207-890-2372
Mailing Address - Fax:
Practice Address - Street 1:7 PORTLAND ST
Practice Address - Street 2:
Practice Address - City:RUMFORD
Practice Address - State:ME
Practice Address - Zip Code:04276-2050
Practice Address - Country:US
Practice Address - Phone:207-364-2969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-01
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR4506183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist