Healthcare Provider Details
I. General information
NPI: 1114273398
Provider Name (Legal Business Name): KATHERINE SRSEN RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/25/2012
Last Update Date: 07/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2300 JANE ST
PITTSBURGH PA
15203-2361
US
IV. Provider business mailing address
66 S 22ND ST
PITTSBURGH PA
15203-2134
US
V. Phone/Fax
- Phone: 412-431-6773
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | RP446765 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: