MEDICARE: DR. KARLA LEIGH CARUSO PHARM D

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	SC12731	SC

General Provider Information

NPI Number	:	1003113267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KARLA LEIGH CARUSO PHARM D

Provider Business Mailing Address
First Line	:	3501 HIGHWAY 153
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29611-7515
Country	:	US
Telephone Number	:	864-295-2029
Fax Number	:

Provider Business Practice Location Address
First Line	:	3501 HIGHWAY 153
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29611-7515
Country	:	US
Telephone Number	:	864-295-2029
Fax Number	:

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

Provider Enumeration Date	:	02/23/2011
Last Update Date	:	12/11/2012

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