Provider Demographics
NPI:1073976908
Name:CARRELLI, MICHAEL (RPH)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:CARRELLI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 PRICKLY BRIAR RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-5661
Mailing Address - Country:US
Mailing Address - Phone:828-231-5911
Mailing Address - Fax:
Practice Address - Street 1:575 NEW LEICESTER HWY
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-2122
Practice Address - Country:US
Practice Address - Phone:828-225-2756
Practice Address - Fax:828-232-4061
Is Sole Proprietor?:No
Enumeration Date:2016-03-29
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7766183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist