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NPI Code Detail

MEDICARE: RUSSEL CARR

MEDICARE: RUSSEL CARR
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
1183500000XPharmacist5302032785MI

General Provider Information

NPI Number : 1922382837
Entity Type Code : Individual
Provider Name (Legal Business Name) : RUSSEL CARR
Provider Business Mailing Address
First Line : 2050 S ROCHESTER RD
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48307-3856
Country : US
Telephone Number : 248-652-4429
Fax Number :
Provider Business Practice Location Address
First Line : 2050 S ROCHESTER RD
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48307-3856
Country : US
Telephone Number : 248-652-4429
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2011
Last Update Date : 10/11/2011

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Directions to “ RUSSEL CARR ” Practice Location

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