Provider Demographics
NPI:1740665520
Name:ENCARNACION, KARLO (PHARMD)
Entity type:Individual
Prefix:
First Name:KARLO
Middle Name:
Last Name:ENCARNACION
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 1:3948 LARCHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-6806
Mailing Address - Country:US
Mailing Address - Phone:757-214-7807
Mailing Address - Fax:
Practice Address - Street 1:3948 LARCHWOOD DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-6806
Practice Address - Country:US
Practice Address - Phone:757-214-7807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-22
Last Update Date:2020-09-01
Deactivation Date:2018-01-24
Deactivation Code:
Reactivation Date:2020-09-01
Provider Licenses
StateLicense IDTaxonomies
VA0202214160183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist