Provider Demographics
NPI:1285987362
Name:ROY, KATELYN S (PHARM D)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:S
Last Name:ROY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:T
Other - Last Name:SOUZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:615 DANIEL WEBSTER HWY
Mailing Address - Street 2:MERRIMACK
Mailing Address - City:MERRIMACK
Mailing Address - State:NH
Mailing Address - Zip Code:03054-2754
Mailing Address - Country:US
Mailing Address - Phone:603-423-9330
Mailing Address - Fax:
Practice Address - Street 1:615 DANIEL WEBSTER HWY
Practice Address - Street 2:MERRIMACK
Practice Address - City:MERRIMACK
Practice Address - State:NH
Practice Address - Zip Code:03054-2754
Practice Address - Country:US
Practice Address - Phone:603-423-9330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-26
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3832183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist