MEDICARE: CAROLINE AMMONS MARKS PHARM D

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	19698	NC

General Provider Information

NPI Number	:	1699929653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINE AMMONS MARKS PHARM D

Provider Business Mailing Address
First Line	:	805 S LONG DR
Second Line	:
City	:	ROCKINGHAM
State	:	NC
Zip	:	28379-4317
Country	:	US
Telephone Number	:	910-997-4471
Fax Number	:	910-997-4471

Provider Business Practice Location Address
First Line	:	805 S LONG DR
Second Line	:
City	:	ROCKINGHAM
State	:	NC
Zip	:	28379-4317
Country	:	US
Telephone Number	:	910-997-4471
Fax Number	:	910-997-4471

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

Provider Enumeration Date	:	11/04/2008
Last Update Date	:	11/04/2008

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