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NPI Code Detail

MEDICARE: MRS. KARRIE ANN ROSE RPH

MEDICARE: MRS. KARRIE ANN ROSE 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
1183500000XPharmacist26016399AIN

General Provider Information

NPI Number : 1396394177
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KARRIE ANN ROSE RPH
Provider Business Mailing Address
First Line : 9008 SEA WIND PL
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-4820
Country : US
Telephone Number : 260-241-1268
Fax Number :
Provider Business Practice Location Address
First Line : 1710 APPLE GLEN BLVD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-1725
Country : US
Telephone Number : 260-432-9330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2019
Last Update Date : 09/05/2019

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