Provider Demographics
NPI:1477898013
Name:BOLES, CARRIE ALLISON (PHARM D)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:ALLISON
Last Name:BOLES
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 1:215 PELHAM RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-2546
Mailing Address - Country:US
Mailing Address - Phone:864-370-8215
Mailing Address - Fax:864-370-8220
Practice Address - Street 1:215 PELHAM RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-2546
Practice Address - Country:US
Practice Address - Phone:864-370-8215
Practice Address - Fax:864-370-8220
Is Sole Proprietor?:No
Enumeration Date:2012-12-09
Last Update Date:2012-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12187183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist