Provider Demographics
NPI:1588203764
Name:CARPENTER, LATOSHA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LATOSHA
Middle Name:
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:LATOSHA
Other - Middle Name:
Other - Last Name:PRESTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4907 MARY BETH BLVD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-9629
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2970 SHASHO PL
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603-4840
Practice Address - Country:US
Practice Address - Phone:301-645-3095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-05
Last Update Date:2020-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26401183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist