Provider Demographics
NPI:1861007072
Name:CARR, EMILE LUGAND (RPH)
Entity Type:Individual
Prefix:MR
First Name:EMILE
Middle Name:LUGAND
Last Name:CARR
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 1:206 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:WRENS
Mailing Address - State:GA
Mailing Address - Zip Code:30833-1109
Mailing Address - Country:US
Mailing Address - Phone:706-547-2225
Mailing Address - Fax:706-547-3012
Practice Address - Street 1:206 E BROAD ST
Practice Address - Street 2:
Practice Address - City:WRENS
Practice Address - State:GA
Practice Address - Zip Code:30833-1109
Practice Address - Country:US
Practice Address - Phone:706-547-2225
Practice Address - Fax:706-547-3012
Is Sole Proprietor?:No
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA11039183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist