Healthcare Provider Details

I. General information

NPI: 1447305347
Provider Name (Legal Business Name): CATHY ANN KNOX RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2022 KELLE DR
CHESTERTON IN
46304-8708
US

IV. Provider business mailing address

2532 WICKER AVE
HIGHLAND IN
46322-1843
US

V. Phone/Fax

Practice location:
  • Phone: 219-395-8100
  • Fax: 219-983-1667
Mailing address:
  • Phone: 219-838-7951
  • Fax: 219-983-1667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26013576A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: