Provider Demographics
NPI:1194311589
Name:CARTER, JEB S (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JEB
Middle Name:S
Last Name:CARTER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5179 CLINTON RD
Mailing Address - Street 2:
Mailing Address - City:STEDMAN
Mailing Address - State:NC
Mailing Address - Zip Code:28391-9516
Mailing Address - Country:US
Mailing Address - Phone:910-483-9482
Mailing Address - Fax:
Practice Address - Street 1:5179 CLINTON RD
Practice Address - Street 2:
Practice Address - City:STEDMAN
Practice Address - State:NC
Practice Address - Zip Code:28391-9516
Practice Address - Country:US
Practice Address - Phone:910-483-9482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-19
Last Update Date:2020-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC265702255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer