MEDICARE: MR. DAVID LYNN CARTER RPH

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	03109568	OH

General Provider Information

NPI Number	:	1871879395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID LYNN CARTER RPH

Provider Business Mailing Address
First Line	:	562 MAIN ST
Second Line	:
City	:	HAMILTON
State	:	OH
Zip	:	45013-3222
Country	:	US
Telephone Number	:	513-867-0252
Fax Number	:	513-867-1327

Provider Business Practice Location Address
First Line	:	562 MAIN ST
Second Line	:
City	:	HAMILTON
State	:	OH
Zip	:	45013-3222
Country	:	US
Telephone Number	:	513-867-0252
Fax Number	:	513-867-1327

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

Provider Enumeration Date	:	10/28/2011
Last Update Date	:	10/28/2011

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