Provider Demographics
NPI:1386767234
Name:ALLPORT, KATHLEEN (PHARM D)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:
Last Name:ALLPORT
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11449 RIVER RUN DR
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-5107
Mailing Address - Country:US
Mailing Address - Phone:804-266-6027
Mailing Address - Fax:
Practice Address - Street 1:500 N HARRISON ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-3008
Practice Address - Country:US
Practice Address - Phone:804-358-4999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202206252183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist