Provider Demographics
NPI:1346559861
Name:ROWE, CARLA GISELLA (RPH)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:GISELLA
Last Name:ROWE
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 1:1845 E BASELINE RD
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-1545
Mailing Address - Country:US
Mailing Address - Phone:480-539-3733
Mailing Address - Fax:480-539-3727
Practice Address - Street 1:1845 E BASELINE RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-1545
Practice Address - Country:US
Practice Address - Phone:480-539-3733
Practice Address - Fax:480-539-3727
Is Sole Proprietor?:No
Enumeration Date:2010-10-01
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS10698183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZS10698OtherPHARMACIST LICENSE