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General NPI Number Information
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NPI Number | 1972637205
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Entity Type | Individual
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Provider Name | STACEY D CARTER R.PH.
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Gender | Female
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 710 MCMEANS AVE PHARMACY DEPT.
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City | BAY MINETTE
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State | AL
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Zip | 36507-3348
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Country | US
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Telephone | 251-937-1101
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Fax | 251-937-1102
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Provider Business Mailing Address
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Address Line | 451 CHARLES V ST
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City | SATSUMA
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State | AL
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Zip | 36572-2821
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Country | US
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Telephone | 251-679-9316
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Fax | 251-937-1102
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 11806
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License Number State | AL
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