1306432075 NPI number — CAROL HOWARD RPH

Table of content: CAROL HOWARD RPH (NPI 1306432075)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306432075 NPI number — CAROL HOWARD RPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOWARD
Provider First Name:
CAROL
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RPH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LAWRENCE
Provider Other First Name:
CAROL
Provider Other Middle Name:
HOWARD
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RPH
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1306432075
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/17/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
888 SHADOW WOOD DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SMITHS STATION
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36877-4869
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
706-442-9974
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CVS PHARMACY # 4934
Provider Second Line Business Practice Location Address:
1430 HWY 280 & 431 N
Provider Business Practice Location Address City Name:
PHENIX CITY
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36867
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-297-6498
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/17/2020

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:  12060 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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