Provider Demographics
NPI:1427688183
Name:CATHCART, JUDITH LYNN
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:LYNN
Last Name:CATHCART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CEDARTOWN
Mailing Address - State:GA
Mailing Address - Zip Code:30125-2358
Mailing Address - Country:US
Mailing Address - Phone:770-749-5095
Mailing Address - Fax:770-749-0228
Practice Address - Street 1:730 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CEDARTOWN
Practice Address - State:GA
Practice Address - Zip Code:30125-2358
Practice Address - Country:US
Practice Address - Phone:770-749-5095
Practice Address - Fax:770-749-0228
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA00235491835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist