Provider Demographics
NPI:1679523948
Name:DOHRN, CARROLL A (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:CARROLL
Middle Name:A
Last Name:DOHRN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 SE CRABAPPLE DR
Mailing Address - Street 2:
Mailing Address - City:WAUKEE
Mailing Address - State:IA
Mailing Address - Zip Code:50263-8175
Mailing Address - Country:US
Mailing Address - Phone:515-978-0313
Mailing Address - Fax:
Practice Address - Street 1:555 51ST ST
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-2831
Practice Address - Country:US
Practice Address - Phone:515-221-2751
Practice Address - Fax:515-225-6197
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20241183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist