Provider Demographics
NPI:1790380673
Name:ZOBEL-TEAGUE, CAROL LYNN (RPH)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:LYNN
Last Name:ZOBEL-TEAGUE
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 1:101 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:RUSHVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46173-1901
Mailing Address - Country:US
Mailing Address - Phone:765-932-4070
Mailing Address - Fax:
Practice Address - Street 1:101 W 1ST ST
Practice Address - Street 2:
Practice Address - City:RUSHVILLE
Practice Address - State:IN
Practice Address - Zip Code:46173-1901
Practice Address - Country:US
Practice Address - Phone:765-932-4070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26017046A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist