MEDICARE: DIANNE C CARPENTER 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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	03-3-26626	OH

General Provider Information

NPI Number	:	1699982751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANNE C CARPENTER PHARMD

Provider Business Mailing Address
First Line	:	313 CENTRAL STATION DR
Second Line	:
City	:	JOHNSTOWN
State	:	OH
Zip	:	43031-9493
Country	:	US
Telephone Number	:	614-348-3641
Fax Number	:

Provider Business Practice Location Address
First Line	:	855 COSHOCTON AVE
Second Line	:
City	:	MOUNT VERNON
State	:	OH
Zip	:	43050-1975
Country	:	US
Telephone Number	:	740-964-5105
Fax Number	:

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

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	05/13/2026

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Directions to “ DIANNE C CARPENTER PHARMD” Practice Location

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