Healthcare Provider Details

I. General information

NPI: 1497308167
Provider Name (Legal Business Name): ASHLEY CARROLL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2019
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 N FRANKLIN ST
BASTROP LA
71220-3846
US

IV. Provider business mailing address

PO BOX 792
BASTROP LA
71221-0792
US

V. Phone/Fax

Practice location:
  • Phone: 318-239-8045
  • Fax:
Mailing address:
  • Phone: 318-283-8887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number47524
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPST.024615
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: