MEDICARE: MR. CARSON MART STRICKLAND RPH

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	13589	CO
2	183500000X	Pharmacist	21085	TX

General Provider Information

NPI Number	:	1306281555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CARSON MART STRICKLAND RPH

Provider Business Mailing Address
First Line	:	7284 LAGAE RD
Second Line	:
City	:	CASTLE PINES
State	:	CO
Zip	:	80108-9451
Country	:	US
Telephone Number	:	303-688-9762
Fax Number	:

Provider Business Practice Location Address
First Line	:	7284 LAGAE RD
Second Line	:
City	:	CASTLE PINES
State	:	CO
Zip	:	80108-9451
Country	:	US
Telephone Number	:	303-688-9762
Fax Number	:

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

Provider Enumeration Date	:	05/01/2013
Last Update Date	:	05/01/2013

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