Provider Demographics
NPI:1427770452
Name:CARTER, RICHARD PAGE IV (PHARM D)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:PAGE
Last Name:CARTER
Suffix:IV
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 MEADOWVALE DR
Mailing Address - Street 2:
Mailing Address - City:WATSONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17777-9526
Mailing Address - Country:US
Mailing Address - Phone:570-490-2697
Mailing Address - Fax:
Practice Address - Street 1:1849 LYCOMING CREEK RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-1523
Practice Address - Country:US
Practice Address - Phone:570-323-1338
Practice Address - Fax:570-323-8476
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP456256183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist