Provider Demographics
NPI:1639478506
Name:MCCARROLL, HELEN A (RPH)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:A
Last Name:MCCARROLL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:TAMAQUA
Mailing Address - State:PA
Mailing Address - Zip Code:18252-2416
Mailing Address - Country:US
Mailing Address - Phone:570-668-6989
Mailing Address - Fax:570-668-6965
Practice Address - Street 1:205 CENTER ST
Practice Address - Street 2:
Practice Address - City:TAMAQUA
Practice Address - State:PA
Practice Address - Zip Code:18252-2416
Practice Address - Country:US
Practice Address - Phone:570-668-6989
Practice Address - Fax:570-668-6965
Is Sole Proprietor?:No
Enumeration Date:2011-03-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP040524L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP040524LOtherSTATE RPH