MEDICARE: CARTERS PHARMACY INC

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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	PHRE007015	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2015949	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093883894
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARTERS PHARMACY INC

Provider Business Mailing Address
First Line	:	1017 US HIGHWAY 80 E STE 10
Second Line	:
City	:	POOLER
State	:	GA
Zip	:	31322-9533
Country	:	US
Telephone Number	:	912-748-1414
Fax Number	:	912-748-4029

Provider Business Practice Location Address
First Line	:	1017 US HIGHWAY 80 E STE 10
Second Line	:
City	:	POOLER
State	:	GA
Zip	:	31322-9533
Country	:	US
Telephone Number	:	912-748-1414
Fax Number	:	912-748-4029

Authorized Official
Title or Position	:	PIC, AO
Name	:	TAMMY SAXON
Credential	:	RPH
Telephone Number	:	912-748-1414

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	07/19/2018

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Directions to “CARTERS PHARMACY INC ” Practice Location

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