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NPI Code Detail

MEDICARE: MRS. CAROLYN MARIE NOLL D.PH.

MEDICARE: MRS. CAROLYN MARIE NOLL D.PH.
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
1183500000XPharmacist15045NC
2183500000XPharmacist39502TX
3183500000XPharmacist14432OK

General Provider Information

NPI Number : 1891021424
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CAROLYN MARIE NOLL D.PH.
Provider Business Mailing Address
First Line : 185 E 33RD ST
Second Line :
City : EDMOND
State : OK
Zip : 73013-4602
Country : US
Telephone Number : 405-348-8328
Fax Number : 405-348-8439
Provider Business Practice Location Address
First Line : 755 RESEARCH PKWY
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73104-3629
Country : US
Telephone Number : 405-330-1457
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2009
Last Update Date : 03/29/2019

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