Provider Demographics
NPI:1528040094
Name:SAXTON, CARLA SUE (RPH, CGP)
Entity Type:Individual
Prefix:MISS
First Name:CARLA
Middle Name:SUE
Last Name:SAXTON
Suffix:
Gender:F
Credentials:RPH, CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4305 LAWRENCE ST
Mailing Address - Street 2:
Mailing Address - City:COLMAR MANOR
Mailing Address - State:MD
Mailing Address - Zip Code:20722-1937
Mailing Address - Country:US
Mailing Address - Phone:703-201-2928
Mailing Address - Fax:703-739-1321
Practice Address - Street 1:1321 DUKE ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-3507
Practice Address - Country:US
Practice Address - Phone:703-739-1316
Practice Address - Fax:703-739-1321
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26019612A183500000X
NC16271183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist