MEDICARE: CARRIE NEAL PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	0202204337	VA
2	183500000X	Pharmacist	09915	SC

General Provider Information

NPI Number	:	1053883868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARRIE NEAL PHARMD

Provider Business Mailing Address
First Line	:	720 MALCOLM BLVD
Second Line	:
City	:	CONNELLY SPRINGS
State	:	NC
Zip	:	28612-7920
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	720 MALCOLM BLVD
Second Line	:
City	:	CONNELLY SPRINGS
State	:	NC
Zip	:	28612-7920
Country	:	US
Telephone Number	:	828-580-6789
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2018
Last Update Date	:	12/19/2018

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Directions to “ CARRIE NEAL PHARMD” Practice Location

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