Provider Demographics
NPI:1043262660
Name:CARTER, PATRICE W (RPH)
Entity Type:Individual
Prefix:MRS
First Name:PATRICE
Middle Name:W
Last Name:CARTER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:BOOTHBAY HARBOR
Mailing Address - State:ME
Mailing Address - Zip Code:04538-2218
Mailing Address - Country:US
Mailing Address - Phone:207-633-4019
Mailing Address - Fax:
Practice Address - Street 1:14 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:BOOTHBAY HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04538-2218
Practice Address - Country:US
Practice Address - Phone:207-633-4019
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME4087183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist