Provider Demographics
NPI:1528266749
Name:CARPENTER, TATIA LYNN (RPH)
Entity type:Individual
Prefix:
First Name:TATIA
Middle Name:LYNN
Last Name:CARPENTER
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 1:1338 WINCHESTER RD NE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35811-8658
Mailing Address - Country:US
Mailing Address - Phone:256-852-3777
Mailing Address - Fax:256-852-6495
Practice Address - Street 1:1338 WINCHESTER RD NE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35811-8658
Practice Address - Country:US
Practice Address - Phone:256-852-3777
Practice Address - Fax:256-852-6495
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11546183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist