Provider Demographics
NPI:1871834580
Name:SOBON, CAROL (RPH)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:
Last Name:SOBON
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 1:6020 MARSHALEE DR
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-5935
Mailing Address - Country:US
Mailing Address - Phone:410-379-6607
Mailing Address - Fax:
Practice Address - Street 1:6020 MARSHALEE DR
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-5935
Practice Address - Country:US
Practice Address - Phone:410-379-6608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-05
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08875183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist