Provider Demographics
NPI:1013914829
Name:CARROLL-GRANT, PAT (RPH)
Entity Type:Individual
Prefix:MS
First Name:PAT
Middle Name:
Last Name:CARROLL-GRANT
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 1:232 MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-1900
Mailing Address - Country:US
Mailing Address - Phone:302-734-1143
Mailing Address - Fax:302-653-0506
Practice Address - Street 1:232 MEADOW DR
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-1900
Practice Address - Country:US
Practice Address - Phone:302-734-1143
Practice Address - Fax:302-653-0506
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLA1-0001866183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist