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General NPI Number Information
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NPI Number | 1073122305
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Entity Type | Individual
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Provider Name | CAITLIN BRIDGET CORKER RELPH PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/22/2020
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Last Update Date | 07/22/2020
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Provider Practice Location Address
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Address Line | 611 ALCORN DR
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City | CORINTH
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State | MS
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Zip | 38834-9388
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Country | US
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Telephone | 662-293-1309
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Fax |
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Provider Business Mailing Address
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Address Line | 716 KILPATRICK ST
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City | CORINTH
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State | MS
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Zip | 38834-4248
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Country | US
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Telephone | 301-606-5987
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | E-15139
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License Number State | MS
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