Provider Demographics
NPI:1124384235
Name:CARPENTER, CINTHEA (RPH)
Entity Type:Individual
Prefix:
First Name:CINTHEA
Middle Name:
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:CINTHEA
Other - Middle Name:
Other - Last Name:MONTGOMERY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:617 O ST APT 4
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-3254
Mailing Address - Country:US
Mailing Address - Phone:907-953-4885
Mailing Address - Fax:
Practice Address - Street 1:4125 DEBARR RD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-3115
Practice Address - Country:US
Practice Address - Phone:907-269-9503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-03
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1699183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist