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NPI Code Detail

MEDICARE: MRS. CATHERINE ANGELA BERGQUIST RPH

MEDICARE: MRS. CATHERINE ANGELA BERGQUIST RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist036203NY

General Provider Information

NPI Number : 1598757833
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CATHERINE ANGELA BERGQUIST RPH
Provider Business Mailing Address
First Line : 376 CLEVELAND AVE
Second Line :
City : HORNELL
State : NY
Zip : 14843-1004
Country : US
Telephone Number : 607-324-1257
Fax Number :
Provider Business Practice Location Address
First Line : 1 BETHESDA DR
Second Line :
City : HORNELL
State : NY
Zip : 14843-1048
Country : US
Telephone Number : 607-324-6935
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2005
Last Update Date : 07/08/2007

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