Healthcare Provider Details

I. General information

NPI: 1184217747
Provider Name (Legal Business Name): KATHRYN CORLETT PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2021
Last Update Date: 02/15/2021
Certification Date: 02/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 W BOWERY ST
AKRON OH
44308-1046
US

IV. Provider business mailing address

1660 HAMILTON DR
BROADVIEW HEIGHTS OH
44147-4400
US

V. Phone/Fax

Practice location:
  • Phone: 330-543-4299
  • Fax:
Mailing address:
  • Phone: 440-539-1219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License Number03135509
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1835P0200X
TaxonomyPediatric Pharmacist
License Number03135509
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03135509
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: