Provider Demographics
NPI:1013117415
Name:HAROLD, CARLA (RPH)
Entity type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:
Last Name:HAROLD
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 1:406 W 34TH ST
Mailing Address - Street 2:SUITE 812
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-2778
Mailing Address - Country:US
Mailing Address - Phone:816-931-2293
Mailing Address - Fax:816-931-5307
Practice Address - Street 1:406 W 34TH ST
Practice Address - Street 2:SUITE 812
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-2778
Practice Address - Country:US
Practice Address - Phone:816-931-2293
Practice Address - Fax:816-931-5307
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002001497183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist