Provider Demographics
NPI:1497204200
Name:ROBERTS, CAROLINE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12051 OLD GLENN HWY
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-7736
Mailing Address - Country:US
Mailing Address - Phone:907-696-4000
Mailing Address - Fax:907-696-4001
Practice Address - Street 1:12051 OLD GLENN HWY
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7736
Practice Address - Country:US
Practice Address - Phone:907-696-4000
Practice Address - Fax:907-696-4001
Is Sole Proprietor?:No
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK114447183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist