Provider Demographics
NPI:1336647007
Name:CARROLL PHARMACY
Entity Type:Organization
Organization Name:CARROLL PHARMACY
Other - Org Name:CARROLL PHARMACY PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:731-925-5551
Mailing Address - Street 1:835 PICKWICK ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:TN
Mailing Address - Zip Code:38372-3006
Mailing Address - Country:US
Mailing Address - Phone:731-925-5551
Mailing Address - Fax:731-925-5724
Practice Address - Street 1:835 PICKWICK ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:TN
Practice Address - Zip Code:38372-3006
Practice Address - Country:US
Practice Address - Phone:731-925-5551
Practice Address - Fax:731-925-5724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-29
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy