Provider Demographics
NPI:1134400260
Name:CARNEY, CORRIE Y (PHARMD)
Entity type:Individual
Prefix:
First Name:CORRIE
Middle Name:Y
Last Name:CARNEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11401 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44105-1801
Mailing Address - Country:US
Mailing Address - Phone:216-751-2902
Mailing Address - Fax:
Practice Address - Street 1:11401 UNION AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44105-1801
Practice Address - Country:US
Practice Address - Phone:216-751-2902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-02
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03325448183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist