Provider Demographics
NPI:1619570140
Name:BENDER, KATHRYN LEE (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:LEE
Last Name:BENDER
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16R RADCLIFFE RD
Mailing Address - Street 2:
Mailing Address - City:BILLERICA
Mailing Address - State:MA
Mailing Address - Zip Code:01821-3243
Mailing Address - Country:US
Mailing Address - Phone:508-733-8889
Mailing Address - Fax:
Practice Address - Street 1:777 ROGERS ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-4336
Practice Address - Country:US
Practice Address - Phone:978-453-7252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR27841183500000X
MAPH27517183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist