Healthcare Provider Details

I. General information

NPI: 1144206228
Provider Name (Legal Business Name): CARRIE DANIELLE THOMAS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 FULTON ST
DURHAM NC
27705-3875
US

IV. Provider business mailing address

814 MILLS ST
RALEIGH NC
27608-1830
US

V. Phone/Fax

Practice location:
  • Phone: 919-755-2620
  • Fax:
Mailing address:
  • Phone: 919-710-4992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number14971
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: