Healthcare Provider Details

I. General information

NPI: 1255621108
Provider Name (Legal Business Name): KATHRYN L. EMENHEISER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2011
Last Update Date: 04/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3205 CAPE HORN RD
RED LION PA
17356-8203
US

IV. Provider business mailing address

3205 CAPE HORN RD
RED LION PA
17356-8203
US

V. Phone/Fax

Practice location:
  • Phone: 717-246-1322
  • Fax: 717-246-5839
Mailing address:
  • Phone: 717-246-1322
  • Fax: 717-246-5839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP031282L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: