Provider Demographics
NPI:1215311097
Name:ASHLEY R CARNAHAN
Entity type:Organization
Organization Name:ASHLEY R CARNAHAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:R
Authorized Official - Last Name:CARAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:719-740-6400
Mailing Address - Street 1:28000 N ELBERT RD
Mailing Address - Street 2:
Mailing Address - City:KIOWA
Mailing Address - State:CO
Mailing Address - Zip Code:80117-8905
Mailing Address - Country:US
Mailing Address - Phone:719-740-6400
Mailing Address - Fax:
Practice Address - Street 1:28000 N ELBERT RD
Practice Address - Street 2:
Practice Address - City:KIOWA
Practice Address - State:CO
Practice Address - Zip Code:80117-8905
Practice Address - Country:US
Practice Address - Phone:719-740-6400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-12
Last Update Date:2015-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA0020063183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty