Healthcare Provider Details

I. General information

NPI: 1205355922
Provider Name (Legal Business Name): DEBORAH KATHIE DOUGLAS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2017
Last Update Date: 09/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3807 W LINCOLN HWY
DOWNINGTOWN PA
19335-2216
US

IV. Provider business mailing address

115 WATCH HILL RD
EAST FALLOWFIELD TOWNSHIP PA
19320-3955
US

V. Phone/Fax

Practice location:
  • Phone: 610-269-0226
  • Fax:
Mailing address:
  • Phone: 484-786-8370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPI011781
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP451934
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: