Provider Demographics
NPI:1043801442
Name:ALLEN, CAROLINE MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:MARIE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11230 KEELER RD
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47012-8953
Mailing Address - Country:US
Mailing Address - Phone:765-265-7348
Mailing Address - Fax:
Practice Address - Street 1:620 RING RD
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:OH
Practice Address - Zip Code:45030-2764
Practice Address - Country:US
Practice Address - Phone:513-202-9600
Practice Address - Fax:513-202-9900
Is Sole Proprietor?:No
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03233433183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist