MEDICARE: CARON P MISITA 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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	16849	NC
2	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	CPP #700070	NC

General Provider Information

NPI Number	:	1588724165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARON P MISITA PHARMD

Provider Business Mailing Address
First Line	:	300 MEADOWMONT VILLAGE CIR
Second Line	:	SUITE 202
City	:	CHAPEL HILL
State	:	NC
Zip	:	27517-7518
Country	:	US
Telephone Number	:	984-974-2950
Fax Number	:	984-974-2924

Provider Business Practice Location Address
First Line	:	300 MEADOWMONT VILLAGE CIR
Second Line	:	SUITE 202
City	:	CHAPEL HILL
State	:	NC
Zip	:	27517-7518
Country	:	US
Telephone Number	:	984-974-2950
Fax Number	:	984-974-2924

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

Provider Enumeration Date	:	12/12/2006
Last Update Date	:	06/03/2015

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