Provider Demographics
NPI:1568823128
Name:MENARD, KARA (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:MENARD
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:554 PARTRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:MICKLETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08056-1339
Mailing Address - Country:US
Mailing Address - Phone:609-221-1141
Mailing Address - Fax:
Practice Address - Street 1:100 BLACK HORSE PIKE
Practice Address - Street 2:
Practice Address - City:AUDUBON
Practice Address - State:NJ
Practice Address - Zip Code:08106-1950
Practice Address - Country:US
Practice Address - Phone:856-616-2484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-10
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02729800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist