Provider Demographics
NPI:1679101810
Name:LEWIS, CARIN (PHARMD, BCPS)
Entity Type:Individual
Prefix:
First Name:CARIN
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7517 VINTON ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-3453
Mailing Address - Country:US
Mailing Address - Phone:515-321-4435
Mailing Address - Fax:
Practice Address - Street 1:7710 MERCY RD STE 102
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2339
Practice Address - Country:US
Practice Address - Phone:402-398-5503
Practice Address - Fax:402-398-5506
Is Sole Proprietor?:No
Enumeration Date:2020-04-01
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13934183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist