Healthcare Provider Details

I. General information

NPI: 1740862820
Provider Name (Legal Business Name): CATHERINE KEW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2021
Last Update Date: 04/27/2021
Certification Date: 04/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6888 N 9TH AVE
PENSACOLA FL
32504-7348
US

IV. Provider business mailing address

4040 LONGWOOD CIR
GULF BREEZE FL
32563-3501
US

V. Phone/Fax

Practice location:
  • Phone: 850-476-0710
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS57902
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: