Provider Demographics
NPI:1649567439
Name:BANGS, CAROLYN (RPH)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:BANGS
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 1:3369 PRINCETON RD
Mailing Address - Street 2:T-1946
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-5389
Mailing Address - Country:US
Mailing Address - Phone:513-714-0006
Mailing Address - Fax:
Practice Address - Street 1:3369 PRINCETON RD
Practice Address - Street 2:T-1946
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-5389
Practice Address - Country:US
Practice Address - Phone:513-714-0006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03120802183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist