Provider Demographics
NPI:1932539301
Name:CARREATHERS, CATHY (RPH)
Entity Type:Individual
Prefix:MS
First Name:CATHY
Middle Name:
Last Name:CARREATHERS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MISS
Other - First Name:CATHY
Other - Middle Name:ANN
Other - Last Name:GURLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:PO BOX 2470
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75504-2470
Mailing Address - Country:US
Mailing Address - Phone:800-785-4197
Mailing Address - Fax:877-737-9135
Practice Address - Street 1:5001 N STATE LINE AVE STE C
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-2962
Practice Address - Country:US
Practice Address - Phone:800-785-4197
Practice Address - Fax:877-737-9135
Is Sole Proprietor?:No
Enumeration Date:2013-11-20
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35349183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist