Provider Demographics
NPI:1346340221
Name:WARNER, CAROLINE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:
Last Name:WARNER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:CAROLINE
Other - Middle Name:
Other - Last Name:WARNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:158 SILO RD
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-8029
Mailing Address - Country:US
Mailing Address - Phone:860-667-6750
Mailing Address - Fax:
Practice Address - Street 1:555 WILLARD AVE
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-2631
Practice Address - Country:US
Practice Address - Phone:860-667-6750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7626183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist