Provider Demographics
NPI:1245706415
Name:CARLISLE, ALEXANDRIA MICHAEL (PHARMD)
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:MICHAEL
Last Name:CARLISLE
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 1:3493 PLAIN VIEW CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:ANGIER
Mailing Address - State:NC
Mailing Address - Zip Code:27501-7937
Mailing Address - Country:US
Mailing Address - Phone:919-753-8179
Mailing Address - Fax:
Practice Address - Street 1:2202 WAYNE MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-1724
Practice Address - Country:US
Practice Address - Phone:919-739-5539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC28040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist