Provider Demographics
NPI:1801195714
Name:CARVER, CRAIG WELLS (RPH)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:WELLS
Last Name:CARVER
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 1:398 HUNTERS CT
Mailing Address - Street 2:
Mailing Address - City:BALL GROUND
Mailing Address - State:GA
Mailing Address - Zip Code:30107-4868
Mailing Address - Country:US
Mailing Address - Phone:770-479-6708
Mailing Address - Fax:
Practice Address - Street 1:2323 CANTON HWY
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-4322
Practice Address - Country:US
Practice Address - Phone:770-888-5031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-17
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH012842183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist