MEDICARE: CARRIE MOTT

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	RPH023069	GA

General Provider Information

NPI Number	:	1043613276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARRIE MOTT

Provider Business Mailing Address
First Line	:	1900 E VICTORY DR
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31404-3713
Country	:	US
Telephone Number	:	912-236-0750
Fax Number	:	912-495-0698

Provider Business Practice Location Address
First Line	:	1900 E VICTORY DR
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31404-3713
Country	:	US
Telephone Number	:	912-236-0750
Fax Number	:	912-495-0698

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

Provider Enumeration Date	:	10/02/2014
Last Update Date	:	06/16/2026

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Directions to “ CARRIE MOTT ” Practice Location

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