Provider Demographics
NPI:1598940900
Name:CARTERS PHARMACUTICAL SERVICES INC
Entity Type:Organization
Organization Name:CARTERS PHARMACUTICAL SERVICES INC
Other - Org Name:CARTERS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-562-2763
Mailing Address - Street 1:1528 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64468-2610
Mailing Address - Country:US
Mailing Address - Phone:660-562-2763
Mailing Address - Fax:660-562-2480
Practice Address - Street 1:1528 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:MO
Practice Address - Zip Code:64468-2610
Practice Address - Country:US
Practice Address - Phone:660-562-2763
Practice Address - Fax:660-562-2480
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARTERS PHARMACUTICAL SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-03
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
4520210002Medicare NSC