Provider Demographics
NPI:1861749236
Name:HOFFMAN, KATIE LYNN (PHARMD)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:LYNN
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3311 OAK PARK RD
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-7753
Mailing Address - Country:US
Mailing Address - Phone:803-371-7037
Mailing Address - Fax:
Practice Address - Street 1:1705 EBENEZER RD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1101
Practice Address - Country:US
Practice Address - Phone:803-366-3114
Practice Address - Fax:803-366-3605
Is Sole Proprietor?:No
Enumeration Date:2012-08-05
Last Update Date:2012-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13743183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist