MEDICARE: DR. GARRETT DANIEL CARTER PHARMD

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	17027	OK

General Provider Information

NPI Number	:	1083158422
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARRETT DANIEL CARTER PHARMD

Provider Business Mailing Address
First Line	:	2248 COUNTY ROAD 1280
Second Line	:
City	:	BLANCHARD
State	:	OK
Zip	:	73010-3133
Country	:	US
Telephone Number	:	405-613-5825
Fax Number	:

Provider Business Practice Location Address
First Line	:	13503 S SANTA FE AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73170-7314
Country	:	US
Telephone Number	:	405-300-6418
Fax Number	:	405-300-6417

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

Provider Enumeration Date	:	12/05/2016
Last Update Date	:	12/05/2016

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