Provider Demographics
NPI:1710198056
Name:CARLISLE, AARON HUGH (RPH)
Entity Type:Individual
Prefix:MR
First Name:AARON
Middle Name:HUGH
Last Name:CARLISLE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5324 RIVER RIDGE AVE NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-3664
Mailing Address - Country:US
Mailing Address - Phone:505-922-8929
Mailing Address - Fax:505-830-0411
Practice Address - Street 1:4950 MONTGOMERY BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-1306
Practice Address - Country:US
Practice Address - Phone:505-883-8700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM5898183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist