Provider Demographics
NPI:1306152038
Name:BLOSE, CARRIE LYNNE (RPH)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:LYNNE
Last Name:BLOSE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 POINT PLZ
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-2540
Mailing Address - Country:US
Mailing Address - Phone:724-285-5800
Mailing Address - Fax:724-285-5580
Practice Address - Street 1:178 POINT PLZ
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-2540
Practice Address - Country:US
Practice Address - Phone:724-285-5800
Practice Address - Fax:724-285-5580
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-18
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP035141L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist