Provider Demographics
NPI:1396275897
Name:CARDUCCI, CAROL (RPH)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:CARDUCCI
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 1:4090 OXFORD DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-4551
Mailing Address - Country:US
Mailing Address - Phone:614-582-5097
Mailing Address - Fax:
Practice Address - Street 1:1425 WORTHINGTON CENTRE DR
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-4921
Practice Address - Country:US
Practice Address - Phone:614-841-7412
Practice Address - Fax:614-841-7413
Is Sole Proprietor?:No
Enumeration Date:2017-06-15
Last Update Date:2017-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03117515183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist