Healthcare Provider Details

I. General information

NPI: 1609321033
Provider Name (Legal Business Name): KATIE LOUISE BELLAY PHARM. D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2016
Last Update Date: 08/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3527 CANFIELD RD
YOUNGSTOWN OH
44511-2816
US

IV. Provider business mailing address

2697 HEATHER LN NW
WARREN OH
44485-1237
US

V. Phone/Fax

Practice location:
  • Phone: 330-797-9485
  • Fax:
Mailing address:
  • Phone: 330-979-8793
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03136218-1
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: