Provider Demographics
NPI:1205228616
Name:CAROLL, AMY (RPH)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:CAROLL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8238 PRINCETON GLENDALE RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-1675
Mailing Address - Country:US
Mailing Address - Phone:513-860-5169
Mailing Address - Fax:513-860-5417
Practice Address - Street 1:8238 PRINCETON GLENDALE RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-1675
Practice Address - Country:US
Practice Address - Phone:513-860-5169
Practice Address - Fax:513-860-5417
Is Sole Proprietor?:No
Enumeration Date:2015-02-21
Last Update Date:2015-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-18370183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist