Provider Demographics
NPI:1659797199
Name:KAMDEM KAMDEM, CARINE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CARINE
Middle Name:
Last Name:KAMDEM KAMDEM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:CARINE
Other - Middle Name:
Other - Last Name:KAMSU MOMO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:350 HIGHWAY 62 E
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72653-3629
Mailing Address - Country:US
Mailing Address - Phone:870-424-3814
Mailing Address - Fax:
Practice Address - Street 1:350 HIGHWAY 62 E
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-3629
Practice Address - Country:US
Practice Address - Phone:870-424-3814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-07
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD12511183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist