1487007027 NPI number — DR. LINDSAY IVEY CARTER PHARM.D.

Table of content: DR. LINDSAY IVEY CARTER PHARM.D. (NPI 1487007027)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487007027 NPI number — DR. LINDSAY IVEY CARTER PHARM.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARTER
Provider First Name:
LINDSAY
Provider Middle Name:
IVEY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARM.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
IVEY
Provider Other First Name:
LINDSAY
Provider Other Middle Name:
JILL
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1487007027
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/19/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
102 N HARRIS ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANDERSVILLE
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31082-1736
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
478-552-2521
Provider Business Mailing Address Fax Number:
478-552-3636

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
102 N HARRIS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANDERSVILLE
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31082-1736
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
478-552-2521
Provider Business Practice Location Address Fax Number:
478-552-3636
Provider Enumeration Date:
07/19/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  RPH027485 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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