Provider Demographics
NPI:1699791269
Name:BEDDICK, CATHERINE
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:
Last Name:BEDDICK
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 1:7005 ABINGTON CT
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-8603
Mailing Address - Country:US
Mailing Address - Phone:336-292-6888
Mailing Address - Fax:
Practice Address - Street 1:803 FRIENDLY CENTER RD STE C
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-2024
Practice Address - Country:US
Practice Address - Phone:336-292-6888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC13347183500000X
PARP040000L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist