Provider Demographics
NPI:1184225500
Name:TYLER, CAROL ANN (RPH)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:TYLER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:ANN
Other - Last Name:CASTLEBERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11 ALBACETE WAY
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS VILLAGE
Mailing Address - State:AR
Mailing Address - Zip Code:71909-2776
Mailing Address - Country:US
Mailing Address - Phone:501-984-1823
Mailing Address - Fax:
Practice Address - Street 1:3604 N HIGHWAY 7
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS VILLAGE
Practice Address - State:AR
Practice Address - Zip Code:71909-9607
Practice Address - Country:US
Practice Address - Phone:501-318-0902
Practice Address - Fax:501-318-5299
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11235183500000X
FLPS60320183500000X
ARPD08658183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist