=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639478506
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HELEN A MCCARROLL RPH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/18/2011
-----------------------------------------------------
Last Update Date | 03/18/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 205 CENTER ST
-----------------------------------------------------
City | TAMAQUA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18252-2416
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 570-668-6989
-----------------------------------------------------
Fax | 570-668-6965
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 205 CENTER ST
-----------------------------------------------------
City | TAMAQUA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18252-2416
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 570-668-6989
-----------------------------------------------------
Fax | 570-668-6965
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | RP040524L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------