Provider Demographics
NPI:1255646071
Name:CARROLL, ROBERT L (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:CARROLL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 VARDON LN
Mailing Address - Street 2:
Mailing Address - City:GREENLAND
Mailing Address - State:NH
Mailing Address - Zip Code:03840-2353
Mailing Address - Country:US
Mailing Address - Phone:603-303-6772
Mailing Address - Fax:603-742-2167
Practice Address - Street 1:16 VARDON LN
Practice Address - Street 2:
Practice Address - City:GREENLAND
Practice Address - State:NH
Practice Address - Zip Code:03840-2353
Practice Address - Country:US
Practice Address - Phone:603-303-6772
Practice Address - Fax:603-742-2167
Is Sole Proprietor?:No
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHR2060183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist