Provider Demographics
NPI:1003906546
Name:CARTER'S PHARMACEUTICAL SERVICES, INC.
Entity Type:Organization
Organization Name:CARTER'S PHARMACEUTICAL SERVICES, INC.
Other - Org Name:WESTON PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:THEA
Authorized Official - Middle Name:
Authorized Official - Last Name:KNOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-386-5541
Mailing Address - Street 1:18215 A HWY 45 NORTH
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:MO
Mailing Address - Zip Code:64098
Mailing Address - Country:US
Mailing Address - Phone:816-386-5541
Mailing Address - Fax:816-386-5398
Practice Address - Street 1:18215 A HWY 45 NORTH
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:MO
Practice Address - Zip Code:64098
Practice Address - Country:US
Practice Address - Phone:816-386-5541
Practice Address - Fax:816-386-5398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO55483336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO600588800Medicaid