Healthcare Provider Details
I. General information
NPI: 1164042248
Provider Name (Legal Business Name): KATHERINE ANN RIDEN PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/20/2020
Last Update Date: 08/05/2020
Certification Date: 08/05/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
335 SUTHERLAND DRIVE SALK PAVILION 222
PITTSBURGH PA
15261-6801
US
IV. Provider business mailing address
1842 PARKVIEW BLVD APT 301
PITTSBURGH PA
15217-5203
US
V. Phone/Fax
- Phone: 412-624-5240
- Fax:
- Phone: 772-480-2523
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | PS59923 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | RP454769 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: