Provider Demographics
NPI:1316052004
Name:EDSITTY, CARRIE (PHARM D)
Entity type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:
Last Name:EDSITTY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:
Other - Last Name:ARVISO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:TOHATCHI HEALTH CENTER
Mailing Address - Street 2:07 CHOOSHGAI DRIVE PO BOX 142
Mailing Address - City:TOHATCHI
Mailing Address - State:NM
Mailing Address - Zip Code:87325
Mailing Address - Country:US
Mailing Address - Phone:505-733-8218
Mailing Address - Fax:505-733-2384
Practice Address - Street 1:TOHATCHI HEALTH CENTER
Practice Address - Street 2:07 CHOOSHGAI DRIVE
Practice Address - City:TOHATCHI
Practice Address - State:NM
Practice Address - Zip Code:87325
Practice Address - Country:US
Practice Address - Phone:505-733-8218
Practice Address - Fax:505-733-2384
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM6652183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist