Provider Demographics
NPI:1881928000
Name:CARLISLE MEDICAL INC
Entity type:Organization
Organization Name:CARLISLE MEDICAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLISLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-344-7988
Mailing Address - Street 1:PO BOX 9814
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36691-0814
Mailing Address - Country:US
Mailing Address - Phone:800-553-1783
Mailing Address - Fax:855-451-5140
Practice Address - Street 1:509 BOULEVARD PARK E
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-3425
Practice Address - Country:US
Practice Address - Phone:251-344-7988
Practice Address - Fax:251-343-7682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-21
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN64001925A3336M0002X
COOSP00060453336M0002X
FLPH255973336M0002X
CANRP15553336M0002X
IL54.0179133336M0002X
MDPO62183336M0002X
MN2639343336M0002X
LAPHY.005485-NR3336M0002X
DEA9-00012153336M0002X
KS22-029733336M0002X
MI53010098173336M0002X
IA42013336M0002X
GAPHNR0001893336M0002X
KYAL15133336M0002X
AL1021013336M0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1991543OtherPK