Provider Demographics
NPI:1528500386
Name:BUCKWALTER, KATIE MARIE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:KATIE
Middle Name:MARIE
Last Name:BUCKWALTER
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 1:2674 BUCKWALTER RD
Mailing Address - Street 2:
Mailing Address - City:MANHEIM
Mailing Address - State:PA
Mailing Address - Zip Code:17545-9451
Mailing Address - Country:US
Mailing Address - Phone:717-669-2314
Mailing Address - Fax:
Practice Address - Street 1:2674 BUCKWALTER RD
Practice Address - Street 2:
Practice Address - City:MANHEIM
Practice Address - State:PA
Practice Address - Zip Code:17545-9451
Practice Address - Country:US
Practice Address - Phone:717-669-2314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-10
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP441810183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist