Provider Demographics
NPI:1609049410
Name:COELHO, MARY L (PHARM D)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:L
Last Name:COELHO
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 1:17 CRAMDEN DR
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-4145
Mailing Address - Country:US
Mailing Address - Phone:831-645-9336
Mailing Address - Fax:
Practice Address - Street 1:160 COUNTRY CLUB GATE CTR
Practice Address - Street 2:
Practice Address - City:PACIFIC GROVE
Practice Address - State:CA
Practice Address - Zip Code:93950-5022
Practice Address - Country:US
Practice Address - Phone:831-373-8323
Practice Address - Fax:831-373-5384
Is Sole Proprietor?:No
Enumeration Date:2008-04-12
Last Update Date:2008-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30380183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist