Provider Demographics
NPI:1386927572
Name:EVERETT, CELIA CARPENTER (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CELIA
Middle Name:CARPENTER
Last Name:EVERETT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3852 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-1598
Mailing Address - Country:US
Mailing Address - Phone:919-708-2033
Mailing Address - Fax:
Practice Address - Street 1:2490 N FAIRFIELD RD
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-1787
Practice Address - Country:US
Practice Address - Phone:937-431-8672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22154183500000X
OH03331645-3183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist