Provider Demographics
NPI:1174813695
Name:CACCHIONE, CAROL (PHARMD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:CACCHIONE
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 1:408 S 1ST ST
Mailing Address - Street 2:RITE AID PHARMACY #4641
Mailing Address - City:LA GRANGE
Mailing Address - State:KY
Mailing Address - Zip Code:40031-1399
Mailing Address - Country:US
Mailing Address - Phone:502-222-0322
Mailing Address - Fax:
Practice Address - Street 1:408 S 1ST ST
Practice Address - Street 2:RITE AID PHARMACY #4641
Practice Address - City:LA GRANGE
Practice Address - State:KY
Practice Address - Zip Code:40031-1399
Practice Address - Country:US
Practice Address - Phone:502-222-0322
Practice Address - Fax:502-222-2244
Is Sole Proprietor?:No
Enumeration Date:2011-04-18
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY010830183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist