MEDICARE: CATHERINE SLATTERY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183700000X	Pharmacy Technician	5303008682	MI

General Provider Information

NPI Number	:	1053994145
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE SLATTERY

Provider Business Mailing Address
First Line	:	1112 SCOTT ST
Second Line	:
City	:	MIDLAND
State	:	MI
Zip	:	48642-5108
Country	:	US
Telephone Number	:	810-845-1891
Fax Number	:

Provider Business Practice Location Address
First Line	:	117 N MISSION ST
Second Line	:
City	:	MOUNT PLEASANT
State	:	MI
Zip	:	48858-1819
Country	:	US
Telephone Number	:	989-772-7677
Fax Number	:	989-773-0663

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2021
Last Update Date	:	05/05/2021

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Directions to “ CATHERINE SLATTERY ” Practice Location

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