Provider Demographics
NPI:1215121223
Name:HERRING, CARLA JOHNSON (BS PHARM)
Entity type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:JOHNSON
Last Name:HERRING
Suffix:
Gender:F
Credentials:BS PHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12320 OLDE FARM CIR
Mailing Address - Street 2:
Mailing Address - City:LAURINBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28352-7761
Mailing Address - Country:US
Mailing Address - Phone:910-276-3001
Mailing Address - Fax:910-276-3006
Practice Address - Street 1:140 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-3815
Practice Address - Country:US
Practice Address - Phone:910-276-3001
Practice Address - Fax:910-276-3006
Is Sole Proprietor?:No
Enumeration Date:2007-09-02
Last Update Date:2007-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13504183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist