MEDICARE: CARINA HOLDSWORTH 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	183500000X	Pharmacist	03233155	OH

General Provider Information

NPI Number	:	1801209879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARINA HOLDSWORTH PHARMD

Provider Business Mailing Address
First Line	:	2906 CLEVELAND AVE SW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44707-3624
Country	:	US
Telephone Number	:	330-484-3947
Fax Number	:	330-484-9470

Provider Business Practice Location Address
First Line	:	2906 CLEVELAND AVE SW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44707-3624
Country	:	US
Telephone Number	:	330-484-3947
Fax Number	:	330-484-9470

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

Provider Enumeration Date	:	06/08/2014
Last Update Date	:	06/08/2014

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