Provider Demographics
NPI:1811219900
Name:CARR, DEBRA DENISE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:DENISE
Last Name:CARR
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 1:2018 BUTLER BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30016-9161
Mailing Address - Country:US
Mailing Address - Phone:770-385-6568
Mailing Address - Fax:
Practice Address - Street 1:2018 BUTLER BRIDGE RD
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30016-9161
Practice Address - Country:US
Practice Address - Phone:770-385-6568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH017539183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist