Provider Demographics
NPI:1477789634
Name:BAKER, CAROLYN HARWELL (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:HARWELL
Last Name:BAKER
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1012
Mailing Address - Street 2:110 SOUTH CONGRESS ST
Mailing Address - City:WINNSBORO
Mailing Address - State:SC
Mailing Address - Zip Code:29180-5012
Mailing Address - Country:US
Mailing Address - Phone:803-635-3565
Mailing Address - Fax:803-815-0396
Practice Address - Street 1:110 S CONGRESS ST
Practice Address - Street 2:
Practice Address - City:WINNSBORO
Practice Address - State:SC
Practice Address - Zip Code:29180-1104
Practice Address - Country:US
Practice Address - Phone:803-635-3565
Practice Address - Fax:803-815-0396
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-02
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10155183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist