Provider Demographics
NPI:1376744078
Name:CARR, SUE E (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SUE
Middle Name:E
Last Name:CARR
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 1:21375 MARTINSBURG RD
Mailing Address - Street 2:
Mailing Address - City:DICKERSON
Mailing Address - State:MD
Mailing Address - Zip Code:20842-9282
Mailing Address - Country:US
Mailing Address - Phone:240-489-3046
Mailing Address - Fax:
Practice Address - Street 1:9701 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3326
Practice Address - Country:US
Practice Address - Phone:301-279-6155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12225183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist