Provider Demographics
NPI:1760690036
Name:STEPHENSON, CATHERINE KREMIN (RPH)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:KREMIN
Last Name:STEPHENSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7790 EXETER CT
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-9002
Mailing Address - Country:US
Mailing Address - Phone:330-921-1262
Mailing Address - Fax:
Practice Address - Street 1:1209 BOARDMAN POLAND RD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44514-1933
Practice Address - Country:US
Practice Address - Phone:330-758-0571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-19
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1-13626183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist