Provider Demographics
NPI:1265462832
Name:CARTER, EDWARD LEE (RPH)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:LEE
Last Name:CARTER
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 1:61 DAVIS BR
Mailing Address - Street 2:
Mailing Address - City:EAST POINT
Mailing Address - State:KY
Mailing Address - Zip Code:41216-8704
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5230 KY ROUTE 321
Practice Address - Street 2:SUITE 8
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-9168
Practice Address - Country:US
Practice Address - Phone:606-886-1970
Practice Address - Fax:606-886-3668
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY93631835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy