Katherine Amanda Fox

Individual provider Active NPI Pharmacist · Tabernacle, NJ

NPI 1902401904 · NPPES record last updated Nov 30, 2020

Key facts

NPI
1902401904
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
28RI03584800 (NJ)
Practice address
1497 Route 206
Tabernacle, NJ 08088-8885
Phone
(609) 268-0279
Fax
(609) 268-0694
NPI assigned
Nov 30, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
28RI03584800NJMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
New Jersey CVS Pharmacy LLC Past
since Dec 6, 2020
Accepting new patients
New Jersey CVS Pharmacy LLC Past
since Dec 6, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI03584800 NJ Yes

Addresses

Primary practice location

1497 Route 206
Tabernacle, NJ 08088-8885

Mailing address

1497 Route 206
Tabernacle, NJ 08088-8885
Phone (609) 268-0279

Other providers in Tabernacle, NJ

All providers in Tabernacle, NJ · Pharmacist in New Jersey

Sources for this page

Verify at the official NPI Registry.